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PATIENT CLERICAL REPRESENTATIVE

Company: Cleveland Clinic Indian River Hospital
Location: Vero Beach
Posted on: January 9, 2022

Job Description:

BASIC FUNCTION: Gathers demographic, insurance and basic medical information for the registration of patients into the hospital computer system. Information may be collected from physicians, physician offices, clinics county health department, nursing facilities, other types of provider referrals and/or through interviews with patients and their families. This involves determination and verification of third-party coverage, appropriate coding of financial and demographic data and referral to appropriate resources to apply for alternative methods of funding when third-party coverage or the patient's ability to pay for services does not meet hospital requirements. Assists in ensuring hospital compliance with federal, state and local statues/regulations and provisions of managed care contracts regarding the authorization for, consent to and confidentiality of all services provided to patients.SUPERVISORYACCOUNTABILITY: NoneNATURE AND SCOPE: The position requires daily communication and interaction patients and families, government and third-party payors, nursing staff, and medical records staff.PRINCIPALACCOUNTABILITIES: Supports the mission, vision and values of the hospital.Responsible for working in a safe and protective manner at all times, keeping in mind that safety and environmental hazards are the responsibility of all employees for themselves, other staff members and patients.Gathers information necessary to complete the registration of patients accessing healthcare services through telephone, computer inquiries into multiple data bases and/or interviews with patients and their families.Promotes a positive hospital image to physicians, patients and their families through prompt, courteous reception and processing of all patients.Obtains required signatures for consent to treatment, assignment of benefits, release of information, confirmation of information provided, statements of income/third-party coverage, living will/health care proxy and other federal, state and county forms required.Verifies medical insurance coverage for available benefits and obtains authorization for services. Refers patients to appropriate resources for alternative methods of funding for services when the patient lacks coverage or the ability to pay.Maintains confidentiality of all scheduling, registration and admission information.Refers accounts to case management to obtain authorization prior to admission or treatment for inpatients.Insures all necessary registration information is gathered and is accurate, through quality checks of registrations, verifying demographic and insurance information for accuracy and completeness. Makes necessary corrections.Advises patient of non-coverage, insurance company refusal to authorize treatment or referral and deductible or coinsurance amounts due. Explains hospital payment policies, calculates and collects amounts due from patients and issues receipts.Prepares payments collected for delivery and deposit. Reconciles cash drawer daily.Notifies nursing services and arranges escort of patient to room (in-patient) and directs patient to appropriate ancillary department (out-patient).Posts CPT charges to account. Also, post co pays to the patients account. Must have a working knowledge of ICD-9, CPT Coding and HIPPA regulations.Answers incoming phone calls and able to take reliable messages if necessary, or transfer to correct department. Able to work directly with nurses and physicians.Accurate scanning of medical records into HPF medical record system.Filing of medical records. Able to pull past files and assemble charts for clinical staff.Gathers complete and accurate demographic, insurance and required medical information in a timely manner.These registrations may be completed at any registration area. This includes main admitting, ED registration, lab express, outpatient registrations and the urgent care centers.Obtains copies of living will, power of attorney/healthcare proxy, worker's compensation or other pertinent information.Verifies insurance information provided to confirm eligibility and determines benefits payable for hospital services. Documents the verification on the patient's account.Accurately calculates co-pay or percentage due by patient at the point of service.Posting of CPT charges incurred with ICD-9 Coding with posting patient payments. Balance payments at the end of shift.Advises patient of hospital/urgent care payment policy and collects deductible, co-payment amounts and/or pre-service deposits.Refers patients appropriately to financial counseling.Obtains required signatures on forms for consent to treatments, assignment of benefits, release of information, applications for indigent care and other mandated forms.Complies with Medicare procedures regarding the screening of patients for Medicare secondary-payors by asking and documenting patient response to questionnaires and surveys.Promotes a positive image to physicians, patients and their families through prompt, courteous reception and processing of all patients.Pleasant greeting of patients upon entering the center.Answering all incoming phone calls. Taking phone messages and filing of medical records.Accurate and timely scanning of medical records into CCIRH HPF system.Assembling of patients' charts for clinical staff. Registering out-patient testing, such as labs, x-rays and Coumadin clinic patients.Maintains confidentiality of all scheduling, registration and admission information.Refers accounts to case management to obtain prior to admission or treatment for inpatients.Refers appropriate patients for screening for application to the Medicaid or indigent care programs.Attends in-services and is compliant with essential education without prompting from manager.Performs other duties as assigned.CORECOMPETENCIES: Ability to multi-task and prioritize work load.Effective written and oral communication skills.Delivers excellent customer service.Able to demonstrate flexibility and adapt to change.Able to maintain confidentiality of patient information.Must be well versed with medical terminology and phone etiquette.Previous experience providing customer or patient relations services.Knowledge of third-party payors and reimbursement methodologies.Knowledge of and previous experience with hospital and medical information systems.Healthcare credit and collections experience, including the rules and regulations governing payment, knowledge of governmental signatory and confidentiality guidelines.Ability to type and knowledge of personal computer applications: Microsoft Windows and products such as Word, Excel, Power Point and Access preferred.MINIMUMREQUIREMENTS: High School Diploma or equivalent required; college level course work or degree preferred.Medical terminology, insurance terminology, knowledge of third-party reimbursement including Medicare, Medicaid and managed care for hospital services is preferred.Previous patient access experience in a hospital or equivalent healthcare organization or setting for one to three (1-3) years.One to three (1-3) years' experience with ICD-9 diagnosis codes and CPT procedural coding at in-patient or out-patient facility preferred.Physical Demands: Sedentary light work - lifting up to 15 pounds on an infrequent basis (less than one lift every three minutes). While work is mostly done sitting, a certain amount of walking or standing is often necessary.Ergonomic Risk Factors: Repetition: Repeating the same motion over and over again places stress on the muscles and tendons. The severity of risk depends on how often the action is repeated, the speed of the movement, the required force and muscles involved.Awkward Posture: Posture is the position your body is in and its effect on the muscle groups that are involved in the physical activity. Awkward postures include repeated or prolonged reaching, bending, kneeling, squatting, working overhead with your hands or arms, or holding fixed positions.Working Conditions: Blood borne Pathogen Exposure Risk Category C: NO exposure to blood or body fluids.INDHP

Keywords: Cleveland Clinic Indian River Hospital, Palm Bay , PATIENT CLERICAL REPRESENTATIVE, Other , Vero Beach, Florida

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