Description
At NorthBay Health, the Medical Assistant I / Patient Services Representative provides comprehensive front- and back-office support within NorthBay Health ambulatory practices.
The MAI/PSR performs general front office duties of moderate scope and complexity including reception, registration, appointment scheduling, insurance verification and medical records management functions. Exercises judgment within defined guidelines and functions as part of a clerical, and customer service team in support of Ambulatory Division medical practices. As a Medical Assistant I, this role is also responsible for providing direct patient care in support of a provider in an ambulatory care setting under the direction and supervision of a licensed physician. Distribution of staff and patients may require reassignment to other nursing areas.
PRIMARY JOB DUTIES
Registration and Charge Entry
Gathers, updates and verifies a comprehensive package of registration and insurance/payer information and ensures accurate entry into the EMR.
Provides information to patients regarding the selection process of a care provider, assists in determining insurance eligibility, co-payments, share of costs and other financial responsibilities for services rendered. Obtains signatures on required forms.
Verifies and documents eligibility for all payers at the time of service.
Reviews benefit plan/s with patient to determine specific allowances and/or restrictions based on services requested.
Researches and answers inquiries related to claims, eligibility and referrals.
Collects co-payments, deposits and fees, reconciling all payments at the end of their shift.
Ensures the accuracy of demographic and insurance information in accordance with the policies, procedures and service expectations of each department.
Maintains professional standards by actively participating in committees, inservices and QI activities and standards development.
Acts as a resource to new and existing staff in areas of subject matter expertise.
Presents a professional demeanor in appearance and attitude.
Serves as a job expert in assigned areas.
Provides orientation to new staff as assigned.
Floats to other areas, as requested.
Performs other duties, as assigned.
Appointment Scheduling and Reception:
Obtains complete demographic information for new patients ensuring accurate entry into the EMR. Confirms and accurately updates demographic information for existing patients.
May confirm eligibility and PCP assignment status (Primary Care) for patients prior to scheduling appointment.
Demonstrates effective listening and problem-solving skills to determine appropriate call routing.
Schedules appointments on the phone or in person in accordance with approved protocols and current scheduling policies, procedures and algorithms
Assists with referral coordination/scheduling (Specialty Care).
Monitors provider schedules to ensure appointments are booked for correct type and correct time allocation.
Proactively manages provider schedules for optimal patient access and no-show reduction.
Places confirmation or rescheduling calls in accordance with scripted guidelines and current policy and procedures.
Assists in physician schedule maintenance functions including coordination of physician absences with open appointment times.
Gathers data for provider access audits; provide appointment access for KPI's.
Greets and welcomes patients and assists them with initial questions regarding appointments, payments, schedules, etc.
Medical RecordsAdheres to System policies related confidentiality of medical record information, transcription and copies or distribution of medical record content.
Handles patient documents appropriately to ensure patient confidentiality. Includes handling of medical records outside designated storage area.
Demonstrates understanding of PHI management and HIPAA compliance by successful completion of annual competency validation.
Patient Care
1. Provides direct patient care according to area assigned, per organizational and departmental policies and procedures.
2. Prepares patient for provider including vital signs and collection of clinical data.
3. Administers medications to patients, including, oral, injections, and nebulizer treatments from approved list as ordered by provider.
4. Ensures smooth operation of the provider's office practice.
5. Assists provider and/or performs procedures in assigned area within scope of practice.
6. Documents patient encounters according to nursing policies.
7. Reviews preventative guidelines, patient status regarding these guidelines and arranges for appropriate follow-up.
8. Anticipates need for appropriate Health Education material.
9. Assists provider to ensure follow-up on abnormal results or ongoing problems.
10. Schedules patients for procedures and provides educational materials as necessary.
11. Actively participates in QI activities.
12. Presents a professional demeanor in appearance and attitude.
13. Performs other duties as assigned.
14. Floats to other areas as needed.
15. Collect non-invasive lab specimens.
16. Under the direction of physician, provides specific treatments in accordance with nursing procedures.
Qualifications
Education: High school graduate or equivalent preferred. Some college business or computer course work preferred. Course work in medical terminology preferred. Graduate from an accredited Medical Assistant program. Program or additional classwork in medication administration required.
Licensure/Certification: State or National MA Certification required within 6 months of hire. Current AHA or equivalent CPR/BLS certification required. Certified Phlebotomy Technician highly preferred Program or additional classwork regarding medication administration required within 6 months of hire. MA medication administration competency checklist completion required within 6 months of hire.
Experience / Skills: Two years of customer engagement experience and/or service centered role required. Previous experience with medication administration required. Experience within a healthcare environment in medical record processes, appointment scheduling, referral and authorization processes, registration process, and back office clinical support preferred, ambulatory experience preferred. Excellent customer service skills required. Excellent oral and written communication skills with ability to effectively articulate thoughts into a productive and meaningful discussion. Ability to successfully manage multiple priorities effectively and within expected timeframes. Working knowledge in the areas listed below, required:
Differentiation of the unique characteristics of the following insurance types: Medi-Cal, Medicare, Managed Care, Indemnity and Workers Compensation.
Impact of completeness and accuracy the registration/admission process on successful claims processing and receipt of payment.
Impact of completeness and accuracy the registration process on the delivery of safe, high quality patient care.
Organizational process and procedures
NorthBay Health's Clinical computer systems
Demonstrated service excellence including, but not limited to professionalism, customer focus, compassion, strong listening skills and a warm demeanor. Consistently exhibits empathy, optimism, resourcefulness and cultural competency in interactions with others. Open to learning new things and partnering with others in a collaborative environment. Proven track record of conducting him/herself in a manner that demonstrates an understanding of the unique complexities and challenges of the healthcare environment. Strong organizational skills. Demonstrated effective time management skills. Must demonstrate and maintain current knowledge and skill in providing ambulatory nursing care as appropriate for patients in the following age groups: Geriatric, Adult, Young Adult, Pediatric and Neonatal. Knowledge of medical terminology.
Interpersonal Skills: Demonstrates the True North values. The True North values are a set of value-based behaviors that are to be consistently demonstrated and role modeled by all employees that work at NorthBay Health. The True North values principles consist of Nurture/Care, Own It, Respect Relationships, Build Trust and Hardwire Excellence.
Standards of Performance: Demonstrate performance by adhering to established policies and procedures and exhibiting the defined characteristics associated with attendance and punctuality.
Physical Effort: Attendance is an essential function of the job. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Moderate physical activity including ability to assist patients, frequent ambulation and prolonged standing. Position requires extensive use of computer keyboarding throughout the day.
Hours: Based on business need.
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