Patient Access Spec II-Cancer-Full Time

Department :

37300 Advocate Illinois Masonic Medical Center - Administration : Cancer

Status : Full time

Full time

Benefits Eligible : Hou rs Per Week :

Hou rs Per Week :

Schedule Details / Additional Information :

Monday thru Friday

7 : 00am until 5 : 30pm

Address : 900 W. Nelson St. Chicago, IL 60657

Hours : Monday-Friday, 7 : 00am - 5 : 30pm

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. 6)Participates in pilot patient access projects and provides feedback on process improvements for registration.

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. 7)Accurately reviews physicians orders and schedules future appointments as ordered and documents in Mosiaq.

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)Requests and accepts payments, generates receipts for funds received, and maintains necessary records of payment transactions.

Utilizes automated systems to process check, credit and debit card transactions. Documents in EMR per department standards.

4)Refers uninsured patients to Financial Counselors as needed. 5)Resolves all outstanding registration alerts in AMP or any other quality assurance system related to registration.

Meets or exceeds an accuracy percentage for registration of 99.5%.

Provides point of entry reception service in all Patient Access departments in order to create the highest levels of patient satisfaction, to minimize wait times, and to assist with patient throughput during the patient arrival process.

1)Interacts with patients using AIDET and Behaviors of Excellence. Greets patients and families promptly and with courtesy, assisting with questions and directions.

2)Begins financial clearance process by reviewing patient orders and confirming reason for patient visit verbally. Communicates discrepancies or questions to clinical partners.

Obtain orders from physicians if needed. Ensure that complete narrative diagnosis and signatures are written on order. 3)Partners effectively with ancillary units to facilitate patient arrival.

Must be familiar with testing requirements (i.e. fasting) in order to gauge appropriateness of patient arrival. Communicates patient arrival to departments and call areas if STAT process is required.

4)Maintains knowledge of hospital locations and services. Able to communicate with clear directions 5)Answers all incoming telephone calls according to established department procedure.

6)Directs or escorts patients to service location if required. Works in conjunction with Guest Services to provide escort service to patients.

7)Works as a team player to assist with patient flow management during peak patient volume times. 8)Collaborates with Cancer Center Clinical and Administrative staff, including physicians, to promote high quality patient experiences.

Education / Experience Required :

High school diploma or equivalent. 4-7 years of hospital registration experience. Knowledge of third party payers, regulatory compliance, and industry standards.

Knowledge of patient access systems which include Allegra, NEBO, Baseshield, Care Connection scheduling and Compass web payment.

Medical terminology certification. Superior customer services skills as demonstrated by an annual average Press Ganey courtesy score of 4.

5 or higher (5.0 scale.) Must meet or exceed an annual average registration accuracy level of 99.5%. Must meet or exceed annual department productivity average.

Knowledge, Skills & Abilities Required :

• Successful completion of a data entry assessment Excellent communication and customer service skills. Office equipment knowledge, including computer skills
• Medical terminology preferred within the last five years. CHAA certification within one year of employment.

Physicial Requirements and Working Conditions :

Ability to work weekends, holidays, and different shifts in order to accommodate staffing needs may be required. Must be flexible and possess ability to work in any patient access setting required.

Must possess communication skills in order to perform complete patient interviews, type information into the appropriate fields, and to verbalize patient instructions.

These tasks may be performed face to face with patients and family members, or over the phone with hospital departments and physician offices.

If position has direct patient care or direct patient contact the following lifting requirement supersedes any previous lifting requirement effective 06 / 01 / 2015.

Ability to lift up to 35 pounds without assistance. For patient lifts of over 35 pounds, or when patient is unable to assist with the lift, patient handling equipment is expected to be used, with at least one other associate, when available.

Unique patient lifting / movement situations will be assessed on a case-by-case basis.

About Advocate Health

is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health.

Providing care under the names in Illinois; in the Carolinas, Georgia and Alabama; and in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care.

Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with serving as the academic core of the enterprise.

It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs.

Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs.

Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.