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Required Skills

1. Assists healthcare providers with the patient care process in person, and over the telephone. Practices within scope and current standards of care. Responsible for customer satisfaction.

1. Provides direct patient care that may include working with patients of all ages, in person and over the phone, completing tasks involving the use of assessment, planning, intervention and evaluation skills, and administration of prescribed medications and treatments. All patient care is provided under the direct supervision of the physician and/or mid-level provider.

1. Documents according to scope and current standard of care.

1. Accountable for achieving quality standards. Assists in various aspects of patient flow process including, but not limited to performing front office reception and billing office duties, securing/stocking necessary supplies, preparing exam room and patient for examination, assisting the provider with the exam or procedure, and cleaning/disinfecting exam/treatment area after use, performing various laboratory duties.

1. Responsible for several tasks related to the paper flow through office. This aspect may include, but is not limited to, working with incoming mail and faxed correspondence, assisting in scanning correspondence and paper medical records and conducting quality assurance.   

1. Assists with various aspects of diagnostic testing including obtaining and/or preparing specimens, labeling/recording, and communicating results. Performs miscellaneous CLIA-waived testing. May perform EKG’s/rhythm strips, spirometry, pulse oximetry, nebulizers, as well as other testing outlined by the provider. 

1. Complies with all clinic policies and procedures including, but not limited to blood borne pathogens, chemical safety, laboratory, administrative, and corporate compliance. Applies the Minimum Necessary Standard when accessing protected health information. 

1. Assists in the clinic financial performance in ways which may include, depending on setting: careful use of resources including supplies, equipment, and time; assisting in the collection of upfront copays; ensuring that patients present for check-out; noting when contact or insurance information does not appear current or correct; following policy related to bad debt situations. Obtains appropriate insurance referrals and pre-certifications. 

1. Demonstrates support for and participates in accomplishing team goals and objectives.

1. Performs other related work as required or requested.

*For questions, please email Rapps.Nick@mhsil.com*

Required Skills

1. Identifies, reviews, and facilitates pre-authorization/pre-certification by Medicare, Medicaid, Commercial, and Managed Care payers, for all required services, to ensure provider eligibility requirements are met prior to receiving service. Utilizes appropriate systems/applications/portals and/or communicates with physician offices and third party payers as necessary. 

1. Interprets a patient requisitions and accurately assigns correct diagnosis and procedural codes to visits in accordance with guidelines, maintaining accuracy of dynamic coding and sequencing of codes. Uses all available tools, including software, physicians offices, HIM coding staff etc. to ensure diagnosis codes assigned are correct and accurately represent patient signs, symptoms, and results, and ensures compliant billing and reimbursement.

1. Participates in required continuing education and compliance training programs to maintain an understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques to support the effective application of ICD-10-CM and CPT coding guidelines to outpatient diagnoses and procedures. Staff will maintain up-to-date knowledge of best practices, standards, regulations, Joint Commission on Accreditation of Health Organizations (JCAHO), Centers for Medicare and Medicaid (CMS), Federal Intermediary (FI) and other related organizations. 

1. Responsible for analyzing & evaluating patients’ eligibility and benefits and reviewing reason for visit criteria to ensure all required documentation has been supplied by the ordering/referring physicians, and meets payer specific guidelines for each patient and health plan prior to patients admission for service to reduce claim denials, retrospective medical necessity reviews, and member benefit reductions.

1. Maintains current payer reference manuals based on managed care, commercial, and governmental coverage weekly/monthly updates. Ensures all insurance requirements are met prior to patients’ arrival, including, but not limited to, researching, identifying, and completing pre-authorization requests. Independently tracks status/outcomes of all requests.

1. Maintain current knowledge/database of payers with additional prior authorization requirements for certain specialty services and/or expansions to care coordination programs/networks.

1. Develops a thorough understanding of and a practical knowledge base of the proper use of all payor websites to accurately deliver appropriate information to patients regarding coverage and requirements for precertification of treatment, verification of benefits and self pay information. Assures pre-certification and pre authorization documentation are communicated by physicians offices and entered correctly in the hospital billing system.  Notifies appropriate parties when pre-certification problem/issues arises so that it can be dealt with in a timely fashion minimizing hospital losses as observed by Management, Patient Access Manager and as indicated by Patient Financial Services feedback.

1. Provides administrative support to licensed health professionals to gather and enter pertinent information, supporting Medical Management functions for the Clinical Concurrent Review Team. Interacts with contracted providers and facilities to research issues, collect required information and/or communicate requirements or approval determinations.

1. Provides coordination of benefits for primary, secondary, and tertiary coverage, establishing a uniform order of benefit determination under which plans pay claims, reducing duplication of benefits by permitting a reduction of benefits to be paid by plans that, pursuant to established rules, do not pay primary benefits, and providing greater efficiency in the processing of claims when patients are covered under more than one plan.

1. Coordinates with MMC Patient Financial Services, Managed Care, Social Services, Case Management, Scheduling, and clinical departments to ensure consistent financial documentation across the enterprise, and an interdisciplinary approach to patient and organizational needs.

1. Contacts third party payers and patients as necessary to facilitate timely payments or other required transactions that result in appropriate reimbursement. Maintains revenue cycle integrity.

1. Effectively negotiates with patients and families to explain, collect, and record patient co-pays and/or deposits, within electronic payment system and Cerner registration module. Supports Patient Access Services POS (Point of Service) collection goals as defined by Revenue Cycle leadership and best practice benchmarks.

1. Effectively triages, documents, and initiates referrals of patients to Medicaid vendor and/or for financial assistance. Maintains current knowledge of, and complies with the Illinois Fair Patient Billing Act, Illinois Uninsured Patient Discount Act, and established MMC procedures at all times.  Follows departmental productivity and quality control measures that support the operational goals and benchmarks.

1. Analyzes reports containing rejected accounts from a variety of hospital sources, including Non-Patient Access registration departments, and resolves toward verification of patient benefit eligibility, and subsequent reimbursement from all possible payer sources, or determines suitability for financial assistance.

1. Orients and cross-trains others within assigned area of responsibility as directed and defined by management. May assist other areas within the unit or department, as necessary, during times of special needs or staff absences. May be required to work night or weekend shifts.

1. Understands the functionality of all computer systems related to job function. Assists in mentoring, training, and development of other Patient Access staff; serves as a resource to staff for questions and problem solving. Demonstrates an advanced understanding of third party payer requirements.

1. Ensures compliance with all applicable HIPAA, Joint Commission, CDC, MMC, and state and federal statues, providing required associated literature to patients at all PAS access points. Educates patients regarding Advance Directives, Medicare D prescription coverage, and both Memorial and Illinois Department of Public Health grievance process as appropriate.

1. Meets department and team benchmarks for productivity, accuracy, call abandonment, and point of service collections. Consistently meets or exceeds given goals for each area on a monthly basis.
2. Participates in, and/or leads special projects as requested/assigned by management.

1. Stays abreast of all applicable regulation changes related to Patient Access. Completes all departmental and team required Revenue Cycle education.  Achieves and maintains any/all assigned Revenue Cycle Certification requirements.

1. Recognizes the need for changes in daily routine, willingly alters schedule, completes assignments before leaving, including but not limited to departmental/team assignment lists/reports; giving more than the designated shift assignment when workload dictates and in case of increased work volumes or special projects, works additional hours at least 75% of the time as requested/observed by Management or Patient Access Coordinator.

1. Demonstrates superior patient relations and interpersonal skills; demonstrates an appropriate level of mental and emotional tolerance and even temperament when dealing with staff, patients and general public, using tact, sensitivity and sound judgment.

1. Minimum requirements of an average of 40-45 encounters processed/submitted per day. Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, patient satisfaction and attendance.

1. Attendance at quarterly department meetings mandatory unless absence approved by PAS Management prior to meeting date.

1. Performs other related work as required or requested.

Required Skills

• Perform clerical duties necessary for patient registration into the Radiology information System.

• Transport patient to and from the imaging procedure room.

• Provide patient assistance during the imaging exam process.

• Utilize proper infection control practice.

• Maintain an excellent guest relations rapport with patients, visitors, Physicians and fellow employees.

• Maintain a clean and safe work environment in area of assignment.

• Stock rooms.

• Fold linen.

• Assist imaging staff with inventory management.

• Take call as required.

• Manage phone calls.

• Under direction of the appropriately licensed staff, mix oral contrast per Radiologist approved protocol.

• Under the direction of the appropriately licensed staff, load the pressure injectors per Radiologist approved protocol.

• Performs other related work as required or requested.

Required Skills

1. Carries out patient care program as established by the therapist to patients of all ages.

1. Performs treatment procedures safely and in accordance with American Physical Therapy Association (APTA) standards and department policies.

1. Communicates with the Physical Therapist and other team members to assure effective teamwork within the work setting.

1. Takes appropriate action when warranted by the patient’s condition.

1. Participates in patient care documentation.

1. Maintains the environment and departmental equipment in a neat, functional and safe order.

1. Maintains skills in treatment procedure through utilization of in-service and continuing education opportunities and expertise of other clinical staff personnel.

1. Demonstrates flexibility in daily scheduling of patients

1. Participates in training programs for students, hospital staff and community.

1. Promotes health and safety in the work environment.

1. Actively participates in competency assessment process.

1. Performs other related work as required or requested.

The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job.  Incumbents may be requested to perform tasks other than those specifically presented in this description.

Required Skills

Principal Duties & Responsibilities:
1. Obtain psychiatric social services assessments within 3 working days after admission and record in patient’s record. Assessments must include all regulatory mandated information.

2. Provide group, individual, and family counseling to patients of all ages and their families as requested by physician or multidisciplinary team. Documents in record after each session and supports information needed for Utilization Review criteria and the patient treatment plan.

3. Initiates discharge planning when patient is admitted. Discharge planning is coordinated with physician and interprofessional team. Assures that discharge plans are secured when patient is medically ready for discharge. Assures that all necessary information has been transmitted to next provider of care.

4. Maintains knowledge of community resources.

5. Complies with the Illinois Mental Health Code and Confidentiality Act.

6. Provides leadership role in interprofessional treatment team meetings. .

7. Consults with colleagues for individual treatment planning of unusual patient situations.

8. Provides evidence of continuing education in the profession.

9. Assists, as needed, in the staff training, new employee orientation, student education, community education, in-house activities, and general public relations activities.

10. Aware of and complies with department and hospital policy and procedures.

11. Demonstrates knowledge of care for older adults through accurate assessments, treatment and effective implementation of interventions.

12. Perform other duties as assigned.

The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job. Incumbents may be requested to perform tasks other than those specifically presented in this description.