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State of Washington Classified Job Specification

PATIENT SERVICES LEAD

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PATIENT SERVICES LEAD
284G
Category: Health Care

Definition

Leads Patient Services Representatives and/or other assigned staff and provides support services such as triaging patient telephone calls to medical staff, scheduling appointments, registering patients, maintaining patient records and assembling patient charts, and initiating and processing patient charge documents.

Distinguishing Characteristics

Under general direction, regularly assigns, instructs and checks the work of others.

Typical Work

Directs, schedules and assists in the training of staff; provides feedback to supervisor on staff's performance;

Registers patients; collect and/or updates demographic and financial information; evaluates patient financial status to determine eligibility for care; assigns appropriate payer plans; obtains insurance claim forms and agency authorizations; verifies eligibility and benefits for third-party payers for planned and emergency admissions;

Responds to patient questions; provides directions to specified areas such as various labs, parking and eating facilities; assists patient in accessing hospital and community services by consulting and making referrals to appropriate resources; assists patients and families with telephone calls; maintains confidentiality of patient information;

Makes telephone assessment of patient problem and severity of condition; schedules new, return, ancillary and procedure appointments consistent with patient needs and scheduling guidelines; ensures or obtains authorization; completes required documentation; enters appointment information in on-line appointment system; maintains system by entering cancelled and rescheduled appointments;

Assists in orienting new attendings, residents, students and staff to the clerical operating procedures;

Triages patient telephone calls to medical staff; obtains necessary information for the return call; initiates emergency procedure when necessary;

Communicates various types of information to patients, referral agencies, departments, physicians and the community such as financial arrangements for special programs and experimental protocols, hospital charge estimates, insurance coverage and billing procedures;

Initiates and maintains the organization of the patient chart; coordinates patient records, referrals, special forms, and charge documents to facilitate patient check-in and check-out;

Processes and reconciles patient charge documents, ensuring accuracy; investigates and corrects rejected charges;

Coordinates obtaining interpreters for patients;

Arranges for patient transportation to outside facilities; coordinates patient transportation within facility;

Transcribes, verifies and follows-up written physician orders; processes patient care orders such as completed requisition for exams or equipment;

Participates in preparation and maintenance of policies and procedures for area of responsibility;

Secures and releases patient valuables and belongings;

Coordinates death procedures, including disposition; completes appropriate documentation;

Performs the work of a Patient Services Representative;

Performs related duties as required.

Legal Requirement(s)

There may be instances where individual positions must have additional licenses or certification. It is the employer’s responsibility to ensure the appropriate licenses/certifications are obtained for each position.

Desirable Qualifications

High School graduation or equivalent

AND

three years of general office experience or two years of office or customer service experience in a healthcare setting.

OR

Equivalent education/experience.

Class Specification History

New Class: 2-15-91
Revise Class/Title: 1-19-2001
General revision. Revises class code (formerly 6079), typical work; effective July 1, 2007.

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