GENERAL SUMMARY AND SCOPE
Responsible for performing a variety of duties including but not limited to: greeting patients, vendors, and other visitors and notifying appropriate staff of their arrival, operating telephone console to route incoming calls and place outgoing calls, scheduling of patient appointments, obtaining current and accurate insurance information each visit, verifying coverage through insurance company, obtaining pre-certifications or prior authorizations as needed, maintaining daily accurate records for timely billing of accounts, notifying patients of account status and payments due using collection techniques to assist in keeping accounts receivable current. Assigned to a specific practice but may need to assist in covering other practice sites.
ESSENTIAL TASKS, DUTIES AND RESPONSIBILITIES
Include the following: The required behaviors associated with the following competencies are outlined in the Competencies Section.
1. Obtains, verifies, updates and scans patient information and provides support services to patients and medical staff 2. Verifies patient’s current insurance coverage through insurance websites 3. Collects and posts co-pays and past due balances, and completes any necessary forms obtaining signatures as necessary
4. Obtains prior authorizations and pre-certifications as needed
5. Manages referrals through EMR
6. Follows all incentive guidelines by helping the practice meet a variety of incentive program goals, including Meaningful Use and Patient Centered Medical Home
7. Performs daily banking through Virtual Merchant and FRMC cashiers 8. Prepares a daily financial spreadsheet for practice 9. Ensure the submission of timely, accurate and complete information to the Central Billing Office 10. Uses collection management reports to keep accounts receivable current
11. Looks for instances of Red Flag Identity theft patterns and reports potential threats to Privacy Officer
12. Requests, locates, sends and receives patient medical records according to federal, state or local guidelines
13. Maintains medical appointments for patients
14. Answers phones in a pleasant manner, screens calls following clinic guidelines to appropriately and expeditiously direct caller
15. Maintains clean, orderly waiting area including patient message board, children’s area, and reading materials
16. Organizes and maintains an inventory system to ensure adequate levels of supplies with emphasis on patient care and cost containment
17. Demonstrates Competence related to the application of our core values.
18. Practices all facets of Health & Safety
19. Demonstrates competence in communication, professionalism, organizational and analytical skills, and technical/professional skills and knowledge in performance of duties and responsibilities rendered to the customer population served.
OTHER TASKS, DUTIES AND RESPONSIBILITIES
Demonstrates Service Excellence and ACE.
Performs other duties, as assigned.
KNOWLEDGE, SKILLS AND ABILITIES
Interpersonal: Development and maintenance of effective relationship with medical and administrative staff, patients and families, co-workers and the public. Ability to communicate effectively in writing and verbally with medical and administrative staff, patients and families, co-workers and insurance companies. Skill in preparation and presentation of reports to FPG management as requested. Ability to remain calm and poised in urgent situations.
Critical Thinking: Skill in exercising initiative, judgment, problem solving, and decision making. Skill in analysis and interpretation of data, and preparation of reports. Skill in time management and organization. Ability to prioritize and meet deadlines to avoid crises management.
Knowledge: Organization policies, procedures, systems and objectives. Knowledgeable in medical office procedures and medical terminology with computer and cash handling experience. Governmental regulations and compliance requirements. Computer systems and applications.
MINIMUM JOB REQUIREMENT:
High school graduate; vocational education preferred. Experience in medical ambulatory setting. Current CPR certification or obtained within 3 months of employment and maintained. Proficient in the use of personal computers with strong typing skills. Skilled in the use of Microsoft Outlook, Excel, and Word is desired.
Eligibility: All employees must be able to provide proof of their identity and their right to work in the United States. As a condition of employment, employee will have annual tuberculin testing. Initial testing upon hire will consist of a 2-step tuberculin test, symptom survey, or chest x-ray. Employees can elect to have the Hepatitis vaccine or sign a wavier to decline due to prior vaccination.
Must possess a valid State of Ohio motor vehicle operator’s license and insurable under Firelands auto policy. Employee must provide proof of personal automobile liability insurance coverage upon request.
Ability to work in a safe and efficient manner and maintain an accident free work place, including ability to demonstrate a working knowledge of emergency codes.
Ability to comply with OSHA regulations and CDC standard and transmission based precaution recommendations and to utilize proper personal protective equipment. Ability to comply with provisions of applicable S.D.S. forms.
Successful completion of a 90 day get-acquainted period.
1. BEHAVIOR REFLECTS A HIGH REGARD FOR THE WORTH AND DIGNITY OF OTHERS
a. Conducts and presents self in professional manner
b. Respects the beliefs, culture and ethnic heritage of others
c. Demonstrates awareness of the individual rights of patients
d. Speaks positively about FPG; FRMC and staff at all times
e. Is flexible and adaptive to changes in work processes and functions
f. Adheres to organization’s security and confidentiality policies
2. BEHAVIOR REFLECTS A CONCERTED EFFORT TOWARD EXCELLENCE IN SERVICE
a. Accepts constructive criticism and modifies actions accordingly
b. Adheres to established time frames
c. Actively seeks ways to improve level of performance
3. BEHAVIOR REFLECTS AN OPENNESS AND DIRECTNESS IN INTERACTING WITH OTHERS
a. Expresses self clearly in verbal/written communication
b. Avoids gossip, rumor spreading and destructive communication
c. Solves problems independently
d. Brings issues to Practice Operations Managerss attention when necessary
1. FINANCIAL RESPONSIBILITY
a. Maintains registration, patient insurance, billing and collections and data processing to ensure accurate patient billing and efficient account collection.
b. Works closely with the Practice Operations Managers to monitor and control clinic expenditures to stay within budget
c. Follows financial policies and guidelines to maximize cash flow, including review of patient accounts for delinquency, to minimize risk of financial loss and ensure organizational integrity
2. HUMAN RESOURCES
a. Complies with federal and state regulations by following personnel policies and procedures to protect employees and the organization
b. Participates in training, education and development programs specific to the individual practices and to the overall organization of FPG.
c. Proactive in reporting practice related problems and concerns to the Practice Operations Managers to maintain employee relations in satisfaction and performance
d. Follows work schedule to meet the needs of the practice
3. PLANNING AND MARKETING
a. Serves as a contact to patients looking for an appropriate response to a question or complaint.
b. Assists patients in understanding the health care delivery system by maintaining patient waiting area with approved literature from public health agencies and other outside organizations.
c. Recommend improvements to the customer relations program by recommending improved procedures to meet or exceed the appropriate expectations of patients, staff, and outside stakeholders
4. INFORMATION SYSTEMS
a. Communicates the practice’s ongoing information system needs, such as software, hardware or access, to improve performance and productivity
b. Participates in IS training to continually improve performance for self and organization
5. RISK MANAGEMENT
a. Follows the organization’s established legal structure in order to maintain compliance
b. Advises Practice Operations Managers of conflicts with internal and external stakeholders by communicating complaints immediately within established guidelines in order to avoid litigation
c. Discourages criminal activity by adhering to policies involving personnel and property in order to protect patients and staff and limit financial exposure
d. Maintains the confidentiality of patient, staff, and organizational proprietary information by instituting and monitoring policies to protect the privacy and rights of those entities
e. Reports inappropriate conduct to Practice Operations Managers to protect patients, staff, the FPG organization, and others
6. ORGANIZATIONAL DYNAMICS
a. Promotes organizational and individual success by representing FPGas a respected and visible presence in the Community.
b. Participates in exercises to support and encourage effective teamwork to enhance staff loyalty and productivity
a. Completes maintenance requests to ensure timely repairs and proper functioning of office and medical equipment b. Serves as a role model for customer service, and mentors support staff in the process
c. Supplements FPG practices by helping to cover duties at other practices when additional staff is needed to cover the schedule
d. Collaborates with Practice Operations Managers in the development of policies, procedures, programs, protocols, and systems, to provide an efficient and accurate patient encounter that will improve the organization’s effectiveness, and the quality of patient outcomes
8. PROFESSIONAL RESPONSIBILITY
a. Advances personal knowledge base by pursuing continuing education and credentialing in order to enhance professional competence
b. Promotes individual and organizational integrity by exhibiting ethical behavior to maintain high standards for the organization and its constituents
c. Responds to the needs of others through effective communication, mutual respect, and consistent follow through in order to generate trust and enhance personal effectiveness