Office Specialist

Job Summary

Under general supervision, is responsible for representing Roosevelt General Hospital (RGH) as an exemplary organization in the region. Office Specialists will be the embodiment of the organization’s mission, vision and values. They will greet patients, families and guests upon arrival and assist them in navigating through all aspects of their hospital or clinic visit. The candidate will initiate the department process, inpatient admissions, and transfer paperwork; obtain and verify accurate identification and demographical data for the patient’s permanent medical record and billing. They will coordinate clerical, registration/admission and communication for efficient and effective operations of the department. The candidate will be responsible for assisting patients with insurance options, setting up payment arrangements, collecting insurance co-payments and deposits; obtain comprehensive information to protect the patient’s well-being and the financial interest of the institution. The position is responsible for coordinating any additional care the patient may need inside and outside of our facility. The position is responsible for obtaining prior authorization needed for testing or services.

Essential Functions:

• Registers patients efficiently and accurately, obtaining appropriate signatures, completing all required forms and providing patient information as required by state and federal regulations and departmental guidelines
• Visits patients in their room to complete or validate information
• Conducts financial screening of emergency room patients
• Collects deposits and co-pays when applicable
• Enters relevant information into computer system
• Sets up payment arrangements with self-pay patients
• Assists patients with questions concerning their insurance coverage
• Advises self-pay patients of their medical and dental care options available in the community for future follow-up care
• Explains hospital/clinic regulations, such as visiting hours, payment of accounts, charges, etc.
• Participates in data gathering for financial reporting
• Cross-train to cover admissions clerk
• Greet all patients, families and hospital visitors with a positive, cheerful attitude
• Uphold the mission, vision and values of organization
• Be knowledgeable on all of RGH’s services
• Serve as the main communications person for the department, answering and placing phone calls, taking and relaying messages for clinical staff

• Initiates, maintains, and updates department logbook, patient charts, and other forms (diagnostic requests, workman comp, etc.) originating in the department with accuracy; accesses patient data for nursing and medical staff as needed.
• Admits patients to inpatient status at time of admission

• Ensures department is adequately stocked with necessary clerical supplies, forms, etc. and maintains a neat and orderly work area

• Notifies the client of appointments scheduled, makes follow-up calls to off-site providers to ensure that client kept appointment and reminds provider to submit a Consultation Report
• Maintains competency in obtaining and inputting medical information to and from clinical and /or other information systems including accessing information as required to complete the referral process
• Screen and schedule incoming referrals
• Obtain prior authorization for diagnostic services and procedures
• Establish and maintain relationships with identified service providers
• Utilizes software to code ICD-9 and CPT codes
• Provide basic coverage for Medical Assistant (vitals and rooming patients)

Non-Essential Functions

• Perform other duties as assigned

Professional Requirements

• Maintain patient confidentiality at all times
• Maintain professional uniformed attire, consists of provided RGH shirts
• Complete continued education/training requirements
• Report to work on time and as scheduled
• Wear identification while on duty
• Maintain regulatory requirements, including all state, federal and local regulations
• Represent the organization in a positive and professional manner at all times
• Comply with all organizational policies and standards regarding ethical business practices
• Communicate the mission, ethics and goals of the organization
• Participate in performance improvement and continuous quality improvement activities
• Attend monthly staff meetings

Qualifications

• High school graduate or equivalent
• Medical terminology knowledge preferred.
• Basic computer knowledge
• Typing speed: minimum 40 wpm, computer knowledge
• Spanish speaking is preferred
• Previous hospital registration, billing and collections, financial counseling, and/or customer service experience preferred
• Knowledge of CPT / ICD-10 coding helpful.

Knowledge, Skills, and Abilities

• Must have an enthusiastic and positive attitude
• Possess a genuine desire to help RGH become an exemplary hospital/clinic in the surrounding community and the state
• Ability to work independently, exercise creativity, be attentive to detail, and maintain a positive attitude
• Ability to manage multiple and simultaneous responsibilities and to prioritize duties/tasks
• Ability to initiate communication with patients, their families and hospital visitors
• Must have excellent customer service and communication skills with the ability to effectively calm patients and be able to deal with distressed and/or agitated patients and their families
• Must have a professional demeanor and excellent public relations skills
• Willingness to develop or improve public speaking skills
• Knowledge of medical insurances (Medicare, HMO’s, PPO’s, commercial), EMTALA regulations, hospital billing and collection process
• Must have excellent written skills with knowledge of medical terminology

Physical Requirements and Environmental Conditions

• Work is performed during regular work hours, but may require overtime and/or weekend hours to meet deadlines
• Work in varying degrees of temperature (heated or air conditioned)
• Work under extreme pressures
• Position requires sitting for approximately 4-6 hours per day and walking for 2 hours per day
• Position requires light to moderate work with 50 pounds maximum weight to lift and carry
• Position requires reaching, bending, stooping, and handling objects with hands and/or fingers, talking and/or hearing, and seeing