Job Description
Major Responsibilities: Performs at a higher skill level than the Access Specialist I. Assumes responsibility as a preceptor/trainer and back up Registration Quality Associate as needed. May assume role of in-charge associate if designated by the manager, supervisor, or Lead Patient Access Rep. Must be proficient in all patient access areas, including, but not limited to, ONC registration and other outpatient service codes. Must be proficient in AMG copay collections per department standards. 1)Willing to accept assignment in any Cancer Center patient access department in order to meet patient volumes and daily staffing needs. 2)Serves as an "in charge" associate in when management personnel are not on site. 3)Serves as a preceptor/trainer for new hires in training or for low performers who require mentoring for registration accuracy. May be called upon to perform registration QA reviews for patient access associates or decentralized associates when needed. 4)Performs banking procedures as needed which may include cash balancing and daily deposits with the cashier for AMG and AIMMC physicians copays. 5)Participates on the Peer Interview team for Patient Access departments or decentralized points of registration. 6)Participates in pilot patient access projects and provides feedback on process improvements for registration. 7)Accurately reviews physicians orders and schedules future appointments as ordered and documents. 8)Assures patient receives printed copy of clinic visit summary. Demonstrates competency with all patient access functions, for AMG and AIMMC SCRO systems, and department policies in all assigned areas of Business Services. Interviews, analyzes and records patient demographic and insurance information which serves as the starting point of every patient's clinical and revenue cycle experience. 1)Obtains and records pertinent demographic and insurance information necessary for accuracy in billing, coding and patient discharge follow-up, which includes Allegra, IDX, and Mosiaq. 2)Verifies patient identity and applies patient identification band as required by the "We ID for Patient Safety" policy. Contributes to the reduction of Duplicate Medical Record numbers by using BASEshield software and collecting information categorized as "key identifiers." Maintains patient confidentiality throughout the registration process per HIPPA regulations. 3)Acquires and maintains knowledge of all Medicare, Medicaid and commercial insurance payers rules and regulations. Complies with all Medicare requirements which include completion of the Medicare Secondary Payer questionnaire (MSP), issuing of the Important Message for Medicare (IMM), screening orders for Medical Necessity, and issuing of ABNs when appropriate. 4)Generates, assembles, processes and scans all required documents for the completion of each registration, including face sheets, labels, advance directives, privacy notices, and consent forms. Obtains proper signatures on all required documents. 5)Performs direct admissions to Cancer Center, as scheduled or converts accounts for other in house outpatient services as needed. 6)Verifies accuracy of pre-registered accounts and updates registration as appropriate. 7)Verifies physician/practitioner licensure and verifies that the order is complete with signatures and proper diagnosis information. Contacts physician for real time correction as needed. 8)Participates in achieving department KRA goals (metrics as recorded by the Press Ganey Patient Satisfaction surveys) in terms of courtesy and wait times. Practices AIM (acknowledge-introduce-manage) and patient flow management toward achievement of department KRA goals. 9)Recognizes and facilitates communication obstacles for patients with loss of hearing and/or sight, as well as those who have difficulty with the English language. Secures interpreter and/or other necessary assistance in order to facilitate customer comprehension throughout the registration process. 10)Completes all required department and medical center competencies, including annual CBTs (computer based training.) Contributes to department and medical center KRAs related to Financial Advocacy and clean billing claims. Identifies and obtains needed authorizations, referrals and service approvals from physicians, insurance companies and/or medical management companies. 1)Screens physician orders against medical necessity criteria using compliance checker software. Follows procedures to obtain additional diagnosis information from physicians and initiates the Medicare Advance Beneficiary Notice of Non-Coverage to patients as appropriate. 2)For self pay patients: Partners with Financial Counselor on determining appropriate charges at the time of service and document appropriate in EMR. 3)Request