Clinic Assistant III - Clinic-Heart Ctr (1.0 FTE, Days)
1.0 FTE, 8 Hour Day Shift
At Stanford Children’s Health, we know world-renowned care begins with world-class caring. That's why we combine advanced technologies and breakthrough discoveries with family-centered care. It's why we provide our caregivers with continuing education and state-of-the-art facilities, like the newly remodeled Lucile Packard Children's Hospital Stanford. And it's why we need caring, committed people on our team - like you. Join us on our mission to heal humanity, one child and family at a time.
This paragraph summarizes the general nature, level and purpose of the job.
The Clinic Assistant III functions as a member of the clinic patient care team and is directed by the Clinic Manager or designee. Perform all clerical duties required to complete patient Check-in/Check-out, administer and coordinate the HMO referral and service authorization process, appointment making, new patient insurance verifications, and performs other clinic front desk activities. Resolve patient problems of limited scope and complexity.
The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned.
Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patient’s rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings. Must perform all duties and responsibilities in accordance with the Service Standards of the Hospital(s).
Schedules patient care appointment and edits and maintains patient physician appointments for new and returning patients, using the scheduling system. Links authorization and payment to appointment.
Schedules ancillary services for patients and provides appropriate instructions.
Schedules complex appointments requiring strong knowledge of procedures, department protocols, and timing.
Assures appropriate verifications and authorizations are completed prior to scheduling patients.
Verifies new patient insurance and ensures that patient has appropriate authorization.
Determines when authorization for services is required and ensures authorization is obtained prior to service date. Determines and documents need for signatures for conditions of registration and Medicare secondary payment screen.
Registers patients for clinic visit. Collects patient demographic and insurance/financial data and enters into the system. Functions independently to complete activities related to the registration process. Responsible for completeness, accuracy, and timeliness of data.
Ensures that all scheduled patients are eligible for services requested and/or determines patient eligibility.
Ensures referral authorization is finalized/approved prior to patient visit; reviews missing referral report document and submits referral authorization document to specialty physician for completion of required data elements, and files or routs documents according to established procedures.
Reconciles and processes denied referral and treatment authorizations and notifies patient of denial status and financial implications.
Documents patient liability and communicates this information to the patient and appropriate staff.
Reviews and analyzes all registration edit reports and ensures that corrections to the database are made in a timely fashion.
Greets and welcomes patients and assists them with initial questions regarding appointments, payments, schedules, etc.
Serves as resource to other staff in the area of registration, benefits, and authorization process.
Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
Education: High school diploma or GED equivalent.
Experience: Three years of progressively responsible and direct related work experience.
Knowledge, Skills, and Abilities:
These are the observable and measurable attributes and skills required to perform successfully the essential functions of the job and are generally demonstrated through qualifying experience, education, or licensure/certification.
Ability to interact with families, staff, and peers based on the needs of the individual taking into consideration age, culture, and developmental needs.
Knowledge of medical terminology.
Knowledge of basic computer skills: MS Office (Word, Excel, PowerPoint, and Outlook).
Knowledge of computer systems and software used in functional area.
Knowledge of insurance plan limitations on care, requirements for pre-authorization for services, patient obligations for payment, and reimbursement/billing requirements.
Ability to speak, read, write, and understand effectively at a level appropriate for the job.
Ability to multi-task and change priorities regularly.
Ability to adjust communications to fit the needs and level of understanding of the receiver.
Ability to exercise calmness in stressful situations.
Ability to schedule, coordinate, and track complex surgery scheduling and multiple patient appointments.
Ability to provide leadership and influence others.
Equal Opportunity Employer