HRJD.133 Health Record Scan Clerk s1

HUMAN RESOURCES JOB DESCRIPTIONS / Patient Financial Services SUBJECT: Patient Services Specialist HRJD. 154 JOB DESCRIPTION Patient Services Specialist

Department: Patient Financial Services Reports to: Business Office Manager

Job Duties & Responsibilities

Job Summary: Under the direct supervision of the Business Office Manager, the Patient Services Specialist is responsible for patient financial education, physician office education concerning insurance medical policies, insurance changes and updates relating to procedure authorizations, and the inpatient medical necessity determination.

JOB SPECIFICATIONS

Education: 1. High school diploma 2. A minimum of an Associate’s Degree but preferably a Bachelor’s Degree or 4 years equivalent experience

Experience and Skills: 1. Minimum of two years working in a business healthcare organization 2. Familiarity with marketing principles preferred 3. Some knowledge and understanding of medical insurance benefits and insurance contracts 4. Professional appearance 5. Use of proper grammar, spelling, communication, and customer service skills 6. Leadership experience 7. Excellent Organization skills, Creative, and Analytical skills 8. 10 key operation 9. Computer skills: Microsoft Word, Excel, Power Point 10. Prior experience in or aptitude to effectively develop and present education and other topics to medical and patient individuals and groups

Job Duties: 1. Responsible for reviewing the Major Health Plans, Medical Policies pertaining to Stanislaus Surgical Hospital and its payers 2. Be proactive and creative in providing ways to educate staff and physicians’ office staff of Health Plan Medical Policies, regulatory requirements affecting physician documentation of medical necessity, proper treatment plans and other data affecting optimum payment of health care services to health care providers. 3. Be knowledgeable about insurance authorization changes and requirements 4. Assist in analyzing patient and physician needs related to obtaining services offered by Stanislaus Surgical Hospital and assist in developing plans to effectively meet those needs and in developing more positive working relations with the physicians and patients 5. Be knowledgeable about Medicare LCD changes/documentation/approved diagnosis lists and work to educate physician practices of their needed compliance to ensure proper reimbursement for services 6. Be knowledgeable about Medicare Inpatient regulation changes and prompt and effective in communicating this information to physicians and their office staff 7. Provide back up to the Insurance Verification/Payment Specialist position Original Date: 29-May-15 17-Jul-1517-Jul-15 [5] Approved, Business Office Manager: 29-May-15 Page 2 of 3

HUMAN RESOURCES JOB DESCRIPTIONS / Patient Financial Services SUBJECT: Patient Services Specialist HRJD. 154 8. Work directly with patients who have requested benefit and coinsurance amount responsibilities prior to surgery 9. Work with physician office staff when they have insurance or scheduling questions 10. Review financial responsibilities with patients in advance of scheduled procedures 11. Coordinate financial payments for insured and uninsured patients 12. Review options for uninsured patients 13. Be creative and effective in representing Stanislaus Surgical Hospital to physicians and their practice staffs and patients in promoting excellent care, effective relations and to help meet the goals and needs of Stanislaus Surgical Hospital 14. Working closely with, communicating effectively with and supporting the directions provided through the Business Office Manager 15. Performs other job duties as assigned

Physical Requirements:

For the purpose of the American Disability Act (ADA), this position has been assessed to identify essential and marginal functions. Tasks listed below are considered to be essential functions of the job. Reasonable accommodations may be made for individuals with qualifying disabilities in order to perform the essential function of the job.

1. Work Position

a. Sitting 90% or more

b. Standing 5% or more

c. Walking 5% or more

2. Body Movements

a. Lifting/Carrying up to 20lbs Frequency, less than 15%

b. Bending and stooping Frequency, less than 25%

c. Hand grip, wrist and digital dexterity Frequency, 60%

3. Speaking, hearing and visual acuity to receive and interpret instructions

4. Verbal and written English communication skills

5. Mathematical and reasoning Skills

6. Normal vision range. Ability to distinguish letters, numbers and symbols

7. Requires the use of office equipment, such as computer, telephones, photocopier, and scanner and FAX Machine

Original Date: 29-May-15 17-Jul-1517-Jul-15 [5] Approved, Business Office Manager: 29-May-15 Page 3 of 3

HUMAN RESOURCES JOB DESCRIPTIONS / Patient Financial Services SUBJECT: Patient Services Specialist HRJD. 154 Employee Signature Date

Original Date: 29-May-15 17-Jul-1517-Jul-15 [5] Approved, Business Office Manager: 29-May-15