PATIENT ACCESS REPRESENTATIVE

Patient Access Representative

Department: Medical – Social Services

Reports To: Care Coordination Consult

Supervises: N/A

Classification: Non-Exempt

Job Summary

The Patient Access Representative, under the supervision of the Social Services Director, provides Franklin’s patient access assistance for the Compassionate Use programs, Mobile County drug programs, and serves as the initial contact for non-FPHC provider referral requests. The Patient Access Representative will utilize patient lists from sources such as Medicaid, HealthSprings, etc., to initiate new patient contacts. The Patient Access Representative maintains a pleasant, courteous, and cooperative manner with patients, visitors, external customers, and Center personnel.

Essential Functions

• Answers telephone in a courteous and efficient manner.
• Receives referral requests from non-FPHC providers by telephone or fax and initiates the process per the Referral and Emergency Room Report Management policies and procedures.
• Checks NextGen Medical Information System for chart number, date of birth, age, address, telephone number, assigned FPHC center, date of last visit to FPHC, and insurance information.
• Contacts new patients from source lists such as Medicaid, HealthSprings, etc., to acquaint potential new patients with services offered by Franklin.
• Schedules appointments and makes referrals to medical social workers or case managers.
• Runs Medicaid strips to check current eligibility and assigned provider.
• Assists medical social workers with compliance regulations for use of the Compassionate Care Program.
• Assists patients in obtaining and completing the necessary forms for required services and serves as the central contact person for the process.
• Conducts reference checks and verifies patient information within various programs as instructed by the Social Worker.
• Receives continuous training to assume higher-level responsibilities as dictated by department and program needs.
• Works assigned reports effectively and efficiently.
• Records all activities in the appropriate log for monthly reporting.
• Participates in performance improvement activities and training initiatives as instructed.
• Maintains prompt arrival and regular attendance at work.
• Maintains confidentiality of patient and program information.
• Performs other duties as assigned by the Director of Healthcare Quality or designee.

Customer Satisfaction Requirements

Must provide the very best customer satisfaction to patients, visitors, and co-workers at all times in a professional and courteous manner.

Performance Standards

Performance will be evaluated by the Director of Healthcare Quality or designee annually, wherein a satisfactory overall rating is considered a minimum acceptable level of performance.

Health and Safety

• Must adhere to safety policies and procedures.
• Must receive Safety and Hazardous Communication training annually.
• Must exercise universal precautions and comply with safety standards and procedures.
• Knowledgeable of OSHA and CLIA requirements to assure compliance.

Privacy Rule Compliance Requirements

• Adheres to Health Insurance Portability and Accountability Act (HIPAA Privacy Rule) policies and procedures.
• Must successfully complete Privacy Rule compliance training annually or as revisions are made to the policies and procedures.
• Must comply with Privacy Rule guidelines by learning to protect FPHC patient medical privacy.
• Must comply with Privacy Rule guidelines by appropriately maintaining patient information in compliance with national standards.
• Must comply with Privacy Rule guidelines by providing appropriate security of FPHC patient records.

Protected Health Information (PHI) Access

Restricted: For purposes of HIPAA compliance, this position is classified under Ancillary Providers and is granted restricted access according to workforce member specific job duties or, if for non-treatment purposes, according to the purpose for which the use is intended. Use and disclosure must be in accordance with applicable privacy policies and procedures.

Qualifications

Education and Experience: High school graduate or GED equivalent with one or more years of clerical work experience with a medical entity, such as a hospital, clinic, or physician office. Graduate of an approved Medical Assistant, Allied Health Program, or an equivalent combination of experience, education, or training that provides the required level of knowledge, skills, and ability.

Knowledge, Skills, and Abilities: Medical terminology and knowledge of program guidelines and procedures. Basic office skills such as data entry, filing, phone etiquette, and composition of simple business letters. Experience with software programs such as Word, Excel, and Medical Manager preferred. Effective verbal and written communication and human relations skills are required with internal and external customers in a friendly, cooperative manner. Must exhibit good team spirit, flexibility to undertake a variety of assignments, and the ability to organize time efficiently among a variety of duties.

Other Qualifications: English as first language preferred. Bilingual/bicultural candidates will be considered.

Physical and Mental Demands

Requires eye-hand coordination and manual dexterity. Requires the ability to distinguish letters and symbols and use office equipment such as computer terminals, fax machines, and multi-line telephones. Work is stressful in nature, and the employee must be able to handle stressful situations appropriately. Work is sedentary in nature; however, frequent standing, stooping, bending, lifting, carrying, and walking are required. Work is varied in nature and requires attention to detail. Must be accurate in all functions.

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