Patient Registration Clerk (1)

Description

POSITION OBJECTIVES

The primary purpose of this position is to assist the Patient Registration department in maintaining accurate records of patient information, both hard copy and computer database. The employee obtains all pertinent registration and eligibility information for the determination of eligibility for health care services. Routinely ensures accurate demographic and alternate resource information is collected and reviewed. The Patient Registration Clerk works directly with the Tribal community assisting with updating and utilizing alternate resources.

MAJOR DUTIES AND RESPONSIBILITIES

1. Schedules appointments for the Medical Walk-In Clinic and accurately checks patients in for Medical and Dental Appointments. Provides appropriate assistance and direction to patients regarding services and resources available within Klamath Tribal Health & Family Services.

2. Assist with maintaining current and accurate patient demographics in the Electronic Health Record being utilized by Klamath Tribal Health & Family Services.

3. Interview/screen new and existing patients to ensure required documentation to establish eligibility is provided. Reconcile documents provided to ensure patients meet eligibility requirements to receive health care services through Klamath Tribal Health & Family Services. All registration applications will be submitted to the Patient Registration Manager for final approval of eligibility.

4. Explain IHS and Klamath Tribal Health & Family Services regulations and policies regarding documents needed and eligibility requirements to receive health care services.

5. Check Patient Registration Outlook Email box and Fax Email box on a daily basis; sort and route mail to appropriate parties. Forward new applications and insurance information to the Patient Registration Manager after initial review.

6. Assist with the maintenance of the chart and filing system for Patient Registration records, denials, suspense, referrals, pending applications and other records. File updates and other vital information in Patient Registration charts.

7. Take appropriate action on referrals, records, and alternate resource information from various Tribal Health departments as assigned by the Patient Registration Manager.

8. Track all demographic changes in the notes section of the patient database system. If no demographic changes are made at the patient update, note patient visits on a monthly basis.

9. Complete eligibility verification for all active insurance coverage at the time of patient appointment check-in. Document eligibility responses in the notes section of the patient database system to ensure accurate and up-to-date insurance information is maintained.

10. Assist the department in identifying patients who may be eligible for alternate resources through patient demographic interviews at the time of check-in and utilize databases to identify patient groups that are uninsured.

11. Assist patients who are eligible for alternate resources in completing the application process for services; primarily the Oregon Health Plan. Home visits may be required for patients who are unable to come into complete renewal application process.

12. Serve as a back-up in the absence of the Patient Registration Manager; enter new patients into the patient database system and update existing patient eligibility as necessary.

13. Perform a variety of clerical duties including, but not limited to scanning, photocopying, ordering Patient Registration supplies, and typing program correspondence. Type and reproduce a variety of daily correspondence and documents including but not limited to memorandums, letters and reports from rough draft. Documents obtained from patients will be scanned into charts on a daily basis.

14. Perform audits on the patient database system utilizing the Registration Report component of the system. Check database for errors such as incomplete or missing information and documentation. Make corrections as needed and work towards obtaining missing documentation to ensure their records remain current and in compliance

15. Identify termed Third-Party Liability (TPL) entries such as Worker’s Compensation and Auto & Homeowner Insurance policies. Enter into tracking system the appropriate term date as indicated by carrier.

16. Develop a list of patients whose forms utilized by the Patient Registration Department (AOB, NPP, Patient R&R, Annual Update Forms, etc.) have expired. Work toward assisting patients with completing and obtaining updated forms to ensure records remain compliant and current.

17. Perform semiannual audits for all patients with Medicaid coverage and confirm coverage through DHS system. Enter term dates where appropriate.

18. Audit patient files and make appropriate changes to entered information to ensure uniformity of entries such as address and phone numbers.

19. The incumbent will be called upon to accomplish other tasks within their scope of work.

SUPERVISORY CONTROLS

The immediate supervisor is the Patient Services Manager. Work is normally assigned in terms of objectives to be achieved with standard procedures to be used. The employee carries out detailed instructions given on assignments. Work is reviewed by the supervisor from draft through final. Employee seeks guidance on unusual or difficult matters.

After initial training, recurring assignments are completed independently. Completed work is spot checked for accuracy, adequacy and timeliness, and compliance with policies and procedures.

Requirements

KNOWLEDGE, SKILLS, ABILITIES

Ability to understand and follow patient eligibility requirements, policies, and procedures.

Ability to review patient information, find errors or missing information, and make accurate corrections to electronic records.

Ability to clearly explain eligibility requirements and application steps to patients.

Must have good typing skills. Emphasis will be on accuracy and attention to details.

Skill and ability to operate a computer/word processor in order to accomplish assignments in a proficient manner.

Ability to use and operate Windows and to learn the use of medical office programs.

Average knowledge of grammar, spelling, and punctuation skills.

Knowledge of proper format for letters and other documents, in accordance with instructions.

Knowledge of alternate resources for payment of medical services including Oregon Health Plan, Private Insurance, Medicare, and Third-Party Liability (such as Workers Compensation and Auto & Homeowner Insurance policies)

Knowledge and ability to establish and maintain an effective filing and records management system.

Knowledge and ability to clearly explain patient eligibility for services, Direct Care Eligibility and Purchase and Referred Care Eligibility.

Knowledge and ability to identify documentation for verification of affiliation or membership of a Federally Recognized Tribe.

Ability to communicate orally and in writing. This person should be able to express her/himself in a clear and concise manner for the purposes of correspondence, reports, and instructions, etc., as well as for obtaining information or conveying messages between the supervisor and other staff members.

Ability to function effectively under pressure of time and/or demands of several tasks at once by effectively planning, organizing and prioritizing workload.

Good public relations, customer service and interpersonal relationship skills. Demonstrates the ability to interact effectively with a diverse range of individuals in a professional, respectful and courteous manner. Uses tact, diplomacy, discretion and mature judgment when communicating with patients, coworkers, supervisors and the public.

Ability to perform work and accomplish tasks in accordance with established policies, procedures, practices, and priorities or the office. This includes the ability to plan and organize work using one’s own initiative and to seek information