Contributes as a team member to facilitate and enhance access to, appropriate utilization of, and satisfaction with AHS services by patients and community members. They help to plan and implement advocacy activities through patient and community education and engagement. Job functions span duties in Member Services, Support Services, Clinical Services, and Community Services. The assignment of tasks and the percentage of time spent in each area will be determined by the Community and Patient Relations Manager, in consultation with managers and supervisors in those work areas. This will vary by position and may shift depending on staffing levels (sickness, vacation, leaves) and as patient and community need change.
ESSENTIAL JOB FUNCTIONS:
Support Services Duties:
1. Greet and register patients, update patients’ records, and create and distribute forms related to patients’ visits.
2. Verify insurance and financial status of patients and update records.
3. Determine and explain to patients the extent of their insurance benefits and payment responsibilities, and collect insurance co-payments.
4. Answer and appropriately handle intercom and phone calls. Assess callers’ needs and assist them in getting their needs met.
5. Facilitate internal and external referrals and appointments: Schedule, cancel, and reschedule referrals and appointments as needed. Internally, it includes all AHS services appointments (e.g., medical clinic, eligibility, nutrition, dental, behavioral health, special clinics, health education, etc.). Externally, includes appointments for specialists, hospitals, clinics, diagnostic testing, treatment, and other organizations providing health and social services.
6. Make daily appointment reminder calls to assigned patients.
7. Anticipate and take pro-active steps to identify and avoid patient problems. Facilitate resolution of problems that are within AHS departments, between AHS departments, or involve external organizations, providers, and services. Includes but not limited to billing issues, medication requests/refills/questions, lab results, specimen collection, equipment loan, eligibility, referrals, etc.
8. Assist patients to complete all healthcare-related paperwork, including but not limited to 32 weeks prenatal records, CHDP forms, medical record releases, disability, WIC, pregnancy verification, MSP, and other requests. Process their paperwork.
9. Assist medical records to pull charts, retrieve or return medical records, respond to requests for Release of Medical Records, copy patient records, and participate in the annual purge of medical records.
10. Carry out phone and mail communications with patients related to their health care needs and AHS treatment and services. Includes but is not limited to broken appointments
Waiting Area Duties:
11. Create a welcoming environment in the waiting area that addresses patients’ needs by greeting, scanning for difficulties such as long waits or delays, answering questions, assisting, and directing patients to appropriate services and staff in the organization.
12. Conduct outreach/education activities and patient surveys in the waiting room.
Interpreting and Translating Duties:
13. Provide phone, on-site, and message-relay interpreting services for all healthcare-related interactions between patients and any AHS staff (e.g., front desk interactions, triage, clinicians, billing, perinatal, behavioral health, nutrition, dental, AMSHO, etc.)
14. Provide interpreting services during educational workshops and activities, special events, meetings, hearings, media events, and other organizational activities.
15. Observe current codes of ethics and standards of practice for health care interpreting (e.g., interprets all speakers’ messages accurately and completely; transparently carries out various interpreter interventions, such as cultural brokering, to facilitate clear communication between speakers; etc.)
16. Sight-translate written materials between English and language of service.
17. Interpret over the phone, on occasion, for other health care organizations and providers.
18. Translate written clinic, health education, and organizational materials, acting as primary translator, word-processor, editor, proofreader, and/or back-translator as assigned.
19. Participate in developing and implementing tools and activities to a) assess language proficiency and interpreting skills and b) train and develop language proficiency and medical terminology among AHS staff.
20. Conducts patient financial screening to determine eligibility for County Medical Services Program (CMSP), Medicare, Medi-Cal, Healthy Families, and other payment sources.
21. Assists patients in completing forms and applications for payment programs. Follows up on patients’ pending status for payment programs.
22. Assists patients in selecting a primary care provider and a health insurance plan, including PPO and HMO.
23. Contacts health plan and insurance company to verify patients’ insurance coverage and referral requirement; may assist in completing Medi-Cal applications and perform status follow-up with the county’s Medi-Cal worker.
24. Updates patient financial information.
25. Answer inquiries and provides counseling regarding Medi-Cal and Medicare and their managed care systems, and other social service needs.
26. Answers phone calls and make appointments for members.
27. Assists the Member Services Manager in conducting member exit interviews and in processing monthly member rosters for all AHS’ contracted managed care plans.
28. Provides advocacy for AHS patients/members due to government welfare reform and immigration policies.
29. Conduct medical history intake interviews for all patients including new patients, newborn infants, and perinatal patients.
Patient and Community Health Education Duties:
30. Conduct and document health education and outreach activities on various health topics (e.g., access to health care/health insurance, perinatal, AIDS, smoking cessation, etc.) in a linguistically and culturally appropriate manner with small-large groups and individuals.
31. Perform perinatal intake and appointment arrangements. Participate in planning, implementing, and monitoring changes to improve the quality of perinatal services, particularly for our smaller communities. Includes but not limited to participating in meetings (e.g., perinatal wrap-up, CPHW meetings, labor coach, etc.) and training.
32. Conduct community needs assessments and evaluation activities through various formats (e.g., focus groups, community surveys, patient surveys, key informant interviews) and participate in planning effective programs and services for AHS patients and Asian immigrant communities.
33. Develop and maintain contacts and working relations with staff at other organizations serving the Asian immigrant community. Represent AHS in various community forums and meetings.
34. Coordinate and participate in health education materials development: a) Develop or adapt educational materials for cultural appropriateness in a variety of formats (written, video, displays/posters, PowerPoint presentations, etc.), b) Translate, c) Design, d) Duplicate, e) Review materials for readability, translation quality, and cultural appropriateness, and f) coordinate or participate in Clinic-Health Ed Materials Committee meetings.
35. Patient Leadership Council: a) Identify and recruit potential patients for PLC involvement, b) Plan, attend and facilitate PLC meetings, c) Assist PLC members in identifying and carrying out their plans.