Rehab Patient Access Float and Insurance Verification Specialist

STATEMENT OF PURPOSE

The Rehab Access float & IV Specialist:

• Carry out the mission daily to exceed expectations and be the difference in the lives of those I serve.   
• Commit to excellence:
• Work to achieve department and organizational goals to achieve JRMC’s vision
• Follow JRMC Healthy Roots
• Carries out tasks of patient registration, in depth insurance verification and scheduling.

 This position is a full time - benefited position working 80 hours per two week pay period. Work hours vary between 6:45 a.m. and 4:30 p.m. based on departmental and operational needs. 

JOB FUNCTIONS

Quality:

• Knowledge of medical terminology.
• Assists with maintaining policies and procedures and record keeping systems for the department.
• Interact with patients of all age groups (infants, pediatrics, adolescents, adults, and geriatrics) while performing duties.
• Interviews patients, gathers information, including but not limited to; demographic data, insurance information, and obtains appropriate signatures.  
• Prepares and organizes the daily appointment/treatment schedule for assigned department clerk is supporting.
• Quick register or Pre-registers patients for all appropriate hospital departments, gathering information for the admission process, and giving instructions and other pertinent information to the patient.  
• Accesses and verifies patient insurance information in accordance with privacy and compliance standards, ensuring monthly accuracy.
• Authorized to access patient insurance records and performs monthly verification to ensure accuracy and compliance.
• Inputs patient information into computer and, upon completion, distributes forms to appropriate personnel.
• Understands and can follow a wide variety of insurance rules and guidelines to ensure care provided is covered by insurance.
• Works closely with direct patient care professionals for prior authorizations process of additional services that the patient may need.
• Takes referrals, schedules patients, compiles new charts, maintains current charts/records and enters patient information in the EMR.  
• Monitors workflow and scheduling to improve efficiency and quality of work performed by department employees.
• Maintains communication and promotes cooperation with other departments regarding patient accounts.  
• Check Work queues daily
• Prepares and keeps all position forms and checklists up to date. 
• Completes Insurance verification:
• Website verification or phone call to insurance companies for authorization, special requests, and appeals.
• Must gain knowledge of all patient insurance company requirements and needs to ensure coverage of services
• Enter insurance information in EPIC referrals.  
• Links all referrals to appointments for staff tracking
• Enters occurrence codes into EPIC.
• Manages certification and re-certification requirements for PT, OT, ST teams by sending notes, orders, and evaluations to physicians for signatures, and monitoring legal requirements.
• Completes discharges of charts to ensure all legally required items have been completed
• Assists in performing review of medical records for completion using established standards of practice
• Is a Subject Matter Expert in EPIC functionality and workflows for new hire training, troubleshooting issues, and a staff daily resource.

Service:

• Greets patients and guests upon entering the hospital or assigned department, ascertain needs, and directs appropriately. 
• Assists patients and visitors in the Rehab Department as needed.
• Assists with open and close of Rehab Department
• Screens telephone calls and visitors for the Rehab department staff.
• Answers and screens calls in a prompt, pleasant, and efficient manner takes messages and communicates messages to the appropriate person in assigned area.
• Conducts reminder/preservice calls to patients.  
• Prepare and send patient letters
• Ability to float to Rehab Office Coordinator and Outpatient Access Supervisor position for staffing coverage needs

People:

• Assists in orientation of new staff to the Rehab department. Develops and maintains updates for orientation manuals. Trains new staff in workflows and provides training needed to perform job duties.
• Assists the Rehab Manager in coordinating the staffing schedule. 
• Assists the Rehab Office Coordinator with rehab department insurance verification
• Works with Outpatient Access Supervisor and covers for outpatient access team staffing openings in all areas: specialty clinics, radiology/lab, rehab.

Finance:

• Works closely with Rehab Office coordinator to assist in inquiries about preauthorization.
• Discusses payment arrangements with patients, receives payments and prepares receipts.
• Works closely with the business office in reviewing denials and correcting billing and insurance errors.

Performs other related duties as assigned or requested.

1. Preparation & Training - High school level of knowledge preferred. Encouraged to have background and strong knowledge of medical terminology. Must be able to follow oral or written orders. Good written and verbal communication skills are needed. 
2. Work Experience - Previous work experience not required. Time to reach competency on the job here three months.
3. Attendance - Punctual and regular attendance is an essential responsibility of each employee at JRMC. Employee are expected to report to work as scheduled, on time and prepared to start working. Employees are also expected to remain at work for their entire work schedule.
4. Analytical Ability - Analytical ability is required. Good organizational skills are needed. Requires ability to multitask.
5. Independent Judgement - Independent judgment is often required. Errors in judgment may moderately impact in time public relations or costs primarily within the Rehab Department; must be able to establish priorities of duties to be completed.
6. Contact with Others - High degree of duties involve contact with others; imperative that this person maintain good relationships with co workers, patients families and visitors; must be tactful and maintain telephone courtesy; must be able to exchange information on a factual basis, dispatch verbal or written messages as directed on a timely basis and perform other activities which require courtesy and tact. This position has continuous interaction with all patients and staff.
7. Supervising the Work of Others - None
8. Responsibility for Welfare of Others - The physical and/or emotional well-being of other employees and patients are highly impacted by the performance of the Access Specialist; consequences can be serious; activities during a day impact on the welfare of patients and employees. Responsible for maintaining absolute confidentiality of information; may be required to assist a therapist in the performance of a treatment if needed. 
9. Mental/Visual Effort - Must be able to speak and write the English language in an understandable manner. Work regularly requires the employee to exert a constant level of mental/visual effort. Must demonstrate physical and emotional ability to meet agreed upon work schedule and performance standards required by the position. Work regularly requires the employee to exert a frequent level of mental/visual effort. Must have visual acuity necessary for performing clerical duties and routine procedures.
10. Working Conditions • Majority of position requirements are done within the Rehab Department office; occasional walking, lifting and bending are needed when assisting a therapist in the performance of a treatment, Pace can be demanding and is subject to frequent interruptions. Requires participation in and complies with JRMC Safety Management Program. Maintains knowledge of and observes Standard Precautions. Practices aseptic techniques whenever appropriate. OSHA Job Classification: This position is defined as a Category II: encouraged to wear stockings and closed toe shoes.
11. Physical & Sensory - Effort Requires continuous use of a computer and constant sitting to perform a majority of the responsibilities of this job. Position may have frequent interruptions and often can be loud. Workstation is near coworkers. Each department may vary in temperature.
12. Background - A comprehensive background check and drug screening will be conducted as a condition of employment for this role. 
13. Drug Screen - A urine drug screening is required for all positions and must be completed within 30 days of the date of hire.
14. Physical Requirement - These are physical requirements of the position that may be performed as part of daily duties. Inability to meet one or more of these physical requirements will not automatically disqualify a candidate or employee from the position. Upon request for reasonable accommodation, JRMC may be able to adjust or excuse one or more of these requirements, depending on the requirement, the essential functions to which it relates and the proposed accommodation.

Employee Requirements:

• Visual Observation - Continuously
• Standing - Occasionally
• Walking - Occasionally
• Sitting - Frequently
• Hands and Finger Dexterity - Continuously
• Reaching with Hands and Arms - Continuously
• Climbing - Never    
• Stooping/Kneeling/Crouching/Crawling - Rarely 
• Hearing/Listening - Continuously
• Tasting or Smelling - Rarely  
• Working Inside - Continuously
• Working Outside - Never   
• Working in Extreme Heat - Never 
• Working in Extreme Cold - Never 
• Working with Hazardous Materials - Rarely  
• Noise - Occasionally
• Working in Dirt / Dust - Rarely 
• Driving - Never 

Lifting/Carrying/Pushing/Pulling:     

• Up to 10 pounds - Occasionally
• Up to 25 pounds - Rarely 
• Up to 50 pounds - Rarely 
• Up to 75 pounds - Rarely   
• Up to 100 pounds - Rarely 
• Over 100 pounds - Never