To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
The Patient Financial Access Facilitator is responsible for all functions and processes related to patient check-in, check-out, registration and scheduling. Obtains and updates the patient's demographic and financial information in a sometimes demanding atmosphere utilizing multiple applications to assure timely processing of the patient visit. Performs a variety of functions including accurate patient identification while adhering to Red Flag procedures to ensure patient safety. Must stay abreast of all insurance changes and adheres to managed care requirements and all other information legislated for Health Care as it relates to the health system. Must understand the various insurance carriers' options and completes insurance entry accurately, satisfying billing requirements to ensure a payable account. Verifies eligibility of insurances, identifies and collects co-pay balances, and initiates other funding referrals as outlined by departmental policy when appropriate.
Responsibilities: 1. Registration: Initiates and completes patient visit information in accordance with YNHH department protocol. 1.1. Collects necessary patient demographic and insurance information when completing the registration process. 1.2. Promptly and efficiently accommodates walk-ins/add-on patients by scheduling appointments, visits and updates registration information. 1.3. Provides support in coordinating arrangements for patients who require additional assistance (i.e. non-English speaking, hard of hearing, disabled, etc.). 1.4. Obtains required signatures and ensures appropriate authorizations are obtained. Documents account information and systems appropriately. 1.5. Completes all EMR check-list to ensure that all registration items are satisfied on the patient accounts. 1.6. Must share an equal percentage of patient registration volume as observed by the supervisor and evidenced by review of productivity reports. 2. Scheduling: Accurately and promptly schedules patient appointments per department standards. 2.1. Schedules patient appointments by obtaining all necessary patients demographic and insurance information. Works in collaboration with clinical team to schedule appointments according to facility schedule, staff availability and patient needs. 2.2. Accurately creates and selects proper visit information (i.e. visit type, duration, and provider). Documents appropriate information pertaining to the visit in the appointment note field. 2.3. Ensures that if there is a wait list/recall list for visits, it is checked daily and empty slots are filled. 2.4. Performs other scheduling/rescheduling duties as needed. 3. Insurance: Ensures appropriate financial information is accurately obtained and documented to ensure proper reimbursement to the health system. 3.1. Demonstrates understanding of the various third party payers and accurately completes insurance entry in order to satisfy billing requirements. 3.2. Exhibits understanding of the on-line eligibility system and independent insurance websites including understanding patient's eligibility, determining benefits and patient responsibility due. 3.3. Informs patients of their financial responsibility as it relates to benefits and non-covered balances. Makes all attempts to collect copay and/or deductibles due at point of service. 3.4. Identifies when the patient has a financial need and refers patient to appropriate department for follow up. Acts as a representative of the Hospital by protecting the financial well-being of the patients and the hospital. 3.5. Maintains all required system and web application log in codes to make certain they are active for utilization at all times. 4. Customer Service: Follows Customer Service guidelines in accordance with YNHH department protocol. 4.1. Ensures smooth functioning of all processes in order to ensure a positive patient experience by acknowledging and receiving patients, physicians and visitors to the department following the YNHHS Standard of Professional Behaviors. 4.2. Models customer service standards and demonstrates value for all people in the work environment. Is prompt, courteous and accurate in letting department members know of patient's arrival. 4.3. Works closely with clinical team to ensure timely patient throughput. Notifies clinical team when patients experience delays. Keeps patients informed when delays occur. 4.4. Attends customer service training program to support model behavior. 4.5. Maintains a high regard for patient privacy and ensures the confidentiality of PHI (Patient Health Information). 4.6. Follows department guidelines and identifies events where the service to a customer was less than optimal and appropriately begins and carries through the service recovery process. 4.7. Recognizes when errors or potential problems occur (i.e. discrepancies in patient information and patient ID issues) and takes steps to correct. Works in collaboration with the clinical staff to identify and resolve complex patient identification issues. 4.8. Answers phone by responding no later than the third ring, identifying self and department on each call, asking the caller's permission before putting her/him on 'hold' and is attentive and courteous to the caller. 4.9. Utilizes EPIC Inbasket/Telephone Encounter functionality by recording appropriate information and promptly relaying messages to appropriate personnel. 5. Resource Management: Utilizes Health System and Department resources to effectively support the patient experience. 5.1. Participates in designated committees, staff meetings, workgroups, and attends all in-service to support team building and communication enhancements. 5.2. Demonstrates effective problem solving ability by recognizing potential problems and intervenes to make things right. Develops potential solutions to be presented to management or work teams. 5.3. Ability to assist and act as a resource to other team members with troubleshooting on complex problems, before bringing it to the attention of the Supervisor or senior team member. 5.4. Maintains professional appearance by adhering to the departmental uniform policy. 5.5. Must be proficient in accessing other related system programs and websites, maintaining passwords as required. 5.6. Demonstrates the ability to problem solve and resolve various registration issues as they pertain to the computer systems. 5.7. Knowledgeable of downtime procedures and incident planning. Demonstrates proficiency in understanding EPIC downtime functions including issuing CSN numbers and how to utilize the SRO. Ability to do system recovery including reconciliation. 6. Supports Organizational and Departmental Goals 6.1. Performs all functions in accordance with established policies and procedures. 6.2. Demonstrates and applies sound knowledge of policies and procedures when performing all scheduling and registration functions. 6.3. Communicates effectively with all co-workers, staff from other departments, physicians, and patients addressing any issues affecting workflow. 6.4. Provides written and oral communication to management or senior team member when required. 6.5. Proactively identifies problem prone areas or processes and recommends solutions. Trains fellow employees on correct/new procedures. 6.6. Follows Department Uniform Policy and Dress code Guidelines related to professional, business attire. 6.7. Able to communicate and escalate issues to Managers, Supervisors, Seniors, and lead team members in writing. 7. Performs other duties as assigned by Supervisor. 7.1. Identifies and recommends opportunities to improve Patient Access activities. 7.2. Provides training to other staff members (or temporaries) on a particular job function or projects or demonstrates tasks/duties when required. 7.3. Motivates others to seek solutions throughout the work day and facilitates discussions in the work group to ensure that tasks are completed and goals met. 7.4. Keeps abreast of changing federal, state, and insurance regulations and departmental policies/procedures. 7.5. Exhibits a positive attitude as it relates to interaction with coworkers, performance of job responsibilities, and a genuine interest in the proper performance of job. 7.6. Actively participates in all staff meetings, seminars, training sessions and work groups to advance departmental goals. 7.7. Independently works on special projects as assigned in the area to address issues and meet goals of the department. 7.8. Attends courses as recommended by Supervisor to increase knowledge and technical expertise (i.e. takes classes on communication skills and advanced systems). 7.9. As new releases are implemented and/or procedures are revised, attends training to ensure employee can proficiently perform expected job duties. 7.10. Initiates projects to support the goals of the department.
High school diploma or GED required. Associate degree preferred.
One (1) to two (2) years of work experience in a customer service environment preferably in a hospital/physician office with emphasis on registration, third party insurance verification and financial clearance dealing with all aspects of medical insurance and eligibility requirements preferred.
Self-directed, well organized and exhibiting excellent interpersonal and team oriented skills with a strong ability to interpret insurance benefits and apply to hospital services. Basic computer skills and the ability to adapt to various programs/systems. Capable of balancing appropriate level of intervention and partnering with clinical staff to insure the highest quality of patient care. Spanish speaking required for positions in the PCC.
Effective coordination of patient appointments. Accountable for accurate and timely verification of patient demographic and insurance benefits information. Collects co-pays, deductible and other patient responsibility balances. Identifies non-coverage issues and responds appropriately. Effectively communicates patient responsibility and identifies when patients may need financial assistance and refers to appropriate programs. Must be available to work flexible shifts to meet patient needs including off-shift, weekends and holidays as needed.
Exercises independent judgment, critical thinking around decisions that may impact patient throughput, service excellence and patient care. Requires a clear understanding of policies and procedures related to the scheduling and coordination of patient appointments. Capable of balancing appropriate level of intervention and partnering with clinical staff to ensure the highest quality of patient care. To protect the patient and the Hospital from financial loss, must have the ability to communicate complex requirements across clinical and financial disciplines.