At Central Maine Healthcare our team members are committed to providing exceptional care and experiences for our community and for each other every day.
Position Summary: Reporting directly to the Patient Access Manager, the PATIENT ACCESS SPECIALIST performs patient admitting and registration activities in accordance with established hospital and departmental regulations, policies and procedures. This position is responsible for monitoring and managing the EMPI (Enterprise Master Patient Index) during periods of system downtime and/or hours of non-coverage in the HIM department to include: communications with all areas of the healthcare system affected by duplicate medical record numbers, merging of the duplicate medical records and unmerging as necessary. This job description addresses general requirements for the PATIENT ACCESS SPECIALIST.
Duties and Responsibilities:
Demonstrates Competency in the Following Areas:
1. Completes patient admission/registration process by reviewing all inpatient accounts for completeness and accuracy of the minimum data set (MDS) as well as all required documents. Obtains and documents missing information required for completion of the admission/registration.
2. Uses appropriate work drivers, including just-in-time face sheet prints, to identify admitted patients and review all accounts.
3. Interviews all inpatients (or appropriate responsible persons) who do not have complete MDS information, and/or all required documents, in order to obtain complete and accurate demographic and financial information.
4. Refers all appropriate non-sponsored patients to Program Eligibility Representative.
5. Monitors regional patient and/or guarantor name changes to ensure appropriateness. Communicates inappropriate changes to Supervisor.
6. Receives inter-facility patient transfer information, performs registration and coordinates bed assignment with Nursing Supervisor.
7. Performs ambulance registrations and charge posting within designated deadlines in order to assure revenue is recorded accurately and in a timely fashion.
8. Maintains insurance and employer master files to reflect most current data. Processes faxed copies of insurance cards and updates patient accounts within 24 hours of receipt of fax.
9. Accessible for registrations, patient transfers and/or EMPI functions during entire shift, using a pager as necessary to meet position requirements.
10. During periods of system downtime and/or hours of non-coverage in HIM Department, performs the following key activities:
a. Maintains communication systems for notifying other departments in the event of duplicate medical record number assignment occurring in a real time environment.
b. Accurately distinguishes between surviving and retiring patient medical record numbers to assure synchronization throughout the organization.
c. Performs medical record number merges or “uncombines” in several different electronic medical systems.
d. Performs transfers of patient account information and is able to follow procedure in terms of understanding which type of transaction should be performed depending upon the circumstances of an inaccurate medical record number assignment.
11. Updates patient demographic, financial and compliance information in the McKesson system.
12. Communicates with patients, medical staff and social workers in a confidential, professional manner using tact and diplomacy.
13. Facilitates the collection of co-pays, deductibles and deposits from patients and their families as appropriate. Works with the Insurance Verification team to communicate and advise on patient responsibility.
14. Performs Program Eligibility Specialist duties as required, during absences.
15. Received constructive feedback from the Supervisor and incorporates it into daily operations. Participates in quality reviews.
16. Attends required meetings, workshops and in-services.
17. Performs other duties as assigned.
18. Customer Service: Interacts with all individuals in a consistent manner, providing attention, support, and assistance to foster an environment of exceptional personal service.
a. Maintains a pleasant and helpful demeanor, and presents a professional appearance toward all internal and external customers at all times.
b. Consistently initiates interaction to provide assistance to individuals who may not be direct customers of the employee (i.e. asks patients who appear to be lost if they need assistance in finding their way).
c. Takes appropriate action to recover from a service difficulty, ensuring that the necessary action is taken to affect a resolution to the customer’s problem.
d. Conducts all work activities with respect for coworkers, including the maintenance of a pleasant and professional environment, fostering calmness during stressful situations.
e. Interacts with supervisory personnel in a professional, supportive and courteous manner, venting emotions appropriate to time and place.
f. Demonstrates a commitment to service by consistent attendance and punctuality, scheduling absences according to departmental requirements, and incurring unplanned absences only when unavoidable circumstances exist.
Organizational Requirements:
19. Adheres to dress code, appearance is neat and clean.
20. Completes annual education requirements.
21. Maintains patient confidentiality at all times.
22. Maintains regulatory requirements.
23. Reports to work on time and as scheduled, completes work within designated time.
24. Wears identification while on duty, uses computerized punch time system correctly.
25. Completes inservices and returns in a timely fashion.
26. Attends annual review and department inservices, as scheduled.
27. Attends at least 90% staff meetings annually, reads and returns all monthly staff meeting minutes.
28. Represents the organization in a positive and professional manner.
29. Actively participates in performance improvement and continuous quality improvement (CQI) activities.
30. Complies with all organizational policies regarding ethical business practices.
31. Communicates the mission, ethics and goals of the facility, as well as the focus statement of the department.
32. Confidentiality: Maintains confidentiality of information at all times.
a. Consistently maintains confidentiality of all information gained during the course of employment, respecting the privacy of others.
b. Understands and maintains the confidentiality of information communicated directly from the supervisor, including discussions of a counseling nature.
c. Follows policies and procedures related to medico legal matters, including confidentiality, amendments of medical records, patient rights, medical records as legal evidence and informed consent
d. Copies records according to policy, assuring the appropriateness of the individual requesting information from the record prior to copying, faxing, or phoning any portion of the record.
33. Safety: Demonstrates an understanding of fire and electrical safety, infection control, body mechanics, and related areas, as appropriate to position.
a. Attends mandatory in-services on fire safety, electrical safety, infection control, and body mechanics. Successfully completes competency-based training in each area.
b. Follows all employee health procedures, incident reporting, and infection control requirements at all times, as appropriate to the position.
c. Uses proper body mechanics at all times as required by the physical demands of the position.
d. Maintains a safe work environment and performs duties of the position in a manner consistent with ensuring the safety of self and others.
e. Identifies safety needs in areas outside own work environment, recommending corrective action as appropriate.
34. Expense Control: Performs job duties in a manner that maximizes expense control.
a. Uses supplies, equipment, and utilities in an expeditious manner
b. Consistently recommends methods to control costs while maintaining a high degree of customer service.
c. Performs job tasks efficiently and effectively resulting in no unplanned overtime.
Regulatory Requirements:
• High school graduate or equivalent.
• One to three years relevant experience preferred, including knowledge of admitting and registration policies and procedures.
• Detailed knowledge of department locations and services provided at Central Maine Medical Center preferred.
Language Skills:
• Able to effectively communicate in English and preferably in French, both verbally and in writing.
• Additional languages preferred.
Skills:
• Proficient skills with personal computers and word processing.
• Able to communicate effectively with professional staff, families and patients.
• Detail oriented with a high degree of accuracy.
• Demonstrates a keen understanding of the significant patient safety implications of maintaining a unique patient identifier in the electronic medical record environment.
• Ability to multi-task and work under pressure.
Shift:
● Varies.
Physical Demands:
• For physical demands of position, including vision, hearing, repetitive motion and environment, see following description.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising client care.
If you are passionate about making a difference and are looking for your next great career opportunity, we look forward to reviewing your application!