Job Details

PLEASE NOTE - This position may require temporarily relocation to other TONHC Facilities: Sells Hospital, Santa Rosa Health Center, San Simon Health Center, and San Xavier Health Center.

Position Summary:

Performs various specialized medical records tasks, including obtaining pertinent information to register patients and resolve problems according to established criteria.

Scope of Work: This position is located within the TONHC Hospital and Health Centers. The work involves performing various related steps, processes, or methods such as compiling, recording and reviewing medical record data. The incumbent is under the general supervision of the Supervisor or designee.

Essential Duties and Responsibilities:

• Interview patients to obtain pertinent registration information such as demographic, insurance information, and authorization to bill all alternate resources for health care.
• Determines the eligibility of patients who have not previously been treated at the health center by using TONHC guidelines. This includes interviewing patients to establish a new health record; obtains the certificate of Indian blood and other proof of tribal membership.
• Identifies and obtains authorization for those patients whose health benefits require prior authorization.
• Obtains patient's signature and files necessary forms related to release of medical information, privacy rights, patient rights.
• Accurately maintains third-party information in the RPMS Patient Registration Medicaid/AHCCCS, Private Insurance system.
• Obtains photocopies of private insurance health cards and explains why the TONHC can lawfully bill for services provided to patients (PL-100-713).
• Reestablishes medical records for inactivated patients' charts.
• Assembles the medical record according to TONHC guidelines.
• Enter registration information into the patient registration system (RPMS).
• Check all medical records that are pulled daily for completeness and accuracy.
• Maintains the medical record in strict confidence, assuring information from the record is disclosed in conformance with applicable policies of TONHC and the State of Arizona.
• Schedules appointments for physicians, consultants, specialty clinics, transportation, and special procedures performed at other facilities.
• Coordinates appointments for timeliness to avoid conflicts in inpatient treatment and to meet the schedule of clinics, transportation, and other services.
• Works daily with transportation to coordinate patient arrival and physician's time with the patient.
• Verifies alternate resources and assures the medical record is complete and accurate before transfer.
• Searches the patient's record for specific information to determine the physician's plan of care and the need for lab or x-ray information.
• Assists with the continuity and quality of care through constant monitoring of patient appointments and follow-up.
• Maintains computer-generated lists of all patients seen in special clinics; monitors and reports no-show patients monthly.
• Aggressively follows up on all missed appointments through the use of letters and referrals.
• Receives all incoming telephone calls for the health center; utilizes knowledge of the organization, programs, operations, and procedures to make proper disposition of inquiries.
• Initiates calls or contacts as directed to obtain or furnish information; observes confidentiality rules in retaining and disseminating information.
• Provides management and other administrative reports as required according to established schedule and format.
• Complies with internal controls policies and standards.
• Assists with implementing the TONHC policies and developing procedures to carry out the patient registration function.
• Participates in performance improvement teams and other committees as assigned.
• Contributes to a team effort and performs other job-related duties as assigned.

Knowledge, Skills, and Abilities:

• Knowledge of the Tohono O'odham culture, customs, and traditions.
• Knowledge of applicable federal, state, tribal laws, regulations, and requirements.
• Knowledge of medical terminology and usages, covering the full range of general medical, surgical, pharmaceutical, hospital terms, medical abstracts, and abbreviations.
• Knowledge of medical records management processes and procedures, including medical forms and formats.
• Knowledge of physiology, major anatomical systems, and related disease processes.
• Knowledge of legal regulations and requirements on confidentiality, specifically to the Privacy Act of 1974 and Health Insurance Portability and Accountability Act of 1996 (HIPAA).
• Knowledge of the Freedom of Information Act (FROIA) and the Drug and Alcohol Abuse Resolution.
• Knowledge of performance improvement activities and tools to participate with the Quality First team in identifying and improving processes.
• Knowledge of, and the ability to use, the Resources and Patient Information Management System (RPMS) and Electronic Health Record (EHR).
• Knowledge of TONHC Internal Controls policy and standards for patient registration.
• Skill in operating various word-processing, spreadsheets, and database software programs.
• Skill in providing superior customer service to external and internal customers.
• Skill in reviewing, checking, preparing, and maintaining written and computer files.
• Ability to establish and maintain positive and effective working relationships with other employees and the general public.
• Ability to organize and plan work.
• Ability to work with standardized medical records procedures, regulations, methods, and requirements to perform a full range of medical records clerical assignments.
• Ability to communicate efficiently and effectively both verbally and in writing.
• Ability to work independently, use sound judgment, and meet deadlines.
• Ability to provide accurate reports.

Minimum Qualifications:

• High School Diploma or General Education Diploma; and six months work experience in patient registration, maintenance of medical records, or an equivalent combination of training, education, and work experience closely related to patient registration and the maintenance of medical records.

Licenses, Certifications, Special Requirements:

• Must type 40 WPM.
• Must successfully complete a Medical Terminology course.
• Must have certification in Healthcare Cardio Pulmonary Resuscitation (CPR) and Automated External Defibrillator (AED).
• Upon recommendation for hire, a criminal background and a National FBI fingerprint check are required to determine suitability for employment, including a 39-month driving record.
• May require possessing and maintaining a valid driver's license (no DUIs or major traffic citations within the last three years).
• If required, must meet the Tohono O'odham Nation tribal employer's insurance requirements to receive a driver's permit to operate program vehicles.
• Based on the department's needs, incumbents may be required to demonstrate fluency in both the Tohono O'odham language and English as a condition of employment.