Patient Access Specialist

Patient Access Representative

Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care.

It takes a special person to work for Kaweah Health. We serve a region where the needs are great, which makes the rewards even greater. Every day, we care for people facing unique challenges and in need of healing. Throughout it all, our focus is to make a difference, and we do in the health of our patients, our loved ones, and our community.

Benefits Eligible

Full-Time Benefit Eligible

Work Shift

Day - 8 Hour or less Shift (United States of America)

Department

8590 Precert/Benefits Verification Ensures high quality work of the registration process for patient care services with emphasis on service excellence to customers.

Qualifications

Education Required: High school diploma Preferred: College courses

Experience Preferred: Prior patient access, registration, insurance benefit and medical terminology experience.

Knowledge/Skills/Abilities Excellent communication, customer service and data input skills.

Department Specific Requirements For Patient Access-Emergency Dept: requires Kaweah Health approved crisis intervention training within 60 days of hire/transfer. For Chronic Disease Mgmt Clinic: must be bilingual in Spanish. For Rural Health Clinics: requires Heartsaver AED. For Rural Health Clinics, Urgent Care Centers and GME-Family Medicine Center: prefer bilingual in Spanish, need to be determined by hiring leader at time of job opening based on clinic needs.

Testing For Rural Health Clinics & GME-Family Medicine Center (when testing required), and Chronic Disease Mgmt Clinic: Requires successful completion of the Language Resource Assistant (LRA) test at a General level. LRA is a language assessment test that demonstrates written and oral interpretation/translation technique skills. Test will be administered if selected.

Job Responsibilities

Essential Maintains confidentiality and protects sensitive data at all times. Adheres to organizational and department specific safety standards and guidelines. Registration or Customer Service:

Accurately completes the admission, registration or pre-registration of a patient presenting for services. Obtains Advance Directive for Medical Record. Provides patient with written material as required by State and Federal law. Provides patient with Privacy Notice for HIPAA requirements. Obtains appropriate signature and documents accurately in Patient Management system as required for compliance. Must be accountable for the QA of own work. Utilizes all computer programs and procedures to ensure accuracy. Properly identifies correct patient and affixes an armband for positive identification of patient. Inventories patient belongings. Answers department phones, timely, and professionally. Assists customers timely with patient access concerns. Routes call as appropriate to other staff or location. Provides support for various floors as needed, in the absence of a unit secretary. Is productive during slow times. Ensures that all efforts provide value to and meet the needs of departmental customers. Responsible for securing patient belongings in accordance to the patient belongings policy. Works with physicians' office to obtain orders and assist in obtaining authorization. Understands Medicare coding, diagnosis codes, CPT codes to assure proper billing and use of ABN in order to provide as necessary to patient. Proficiency in the applicable programs. Thoroughly documents activity. Ensures patient has directions to facility/place of service. Answers all inquiries from all customers, both internal and external, in a timely manner whether the inquiries are via telephone, email, fax and in person. Informs patient of necessary requirements, financial obligations, financial discounts and pertinent information regarding their exam. Works closely with Financial Counselors to evaluate patient's financial needs, making appropriate determinations and referral to appropriate agencies for assistance to ensure reimbursement to the Kaweah Health. Obtains any signatures necessary including but not limited to HIPAA, COA, etc. Collects any applicable copayment or deductible and enters it into the patient payment system for a receipt. Answers questions regarding patient accounts. Properly identifies correct patient, correct exam and correct physician to ensure exam accuracy and patient confidentiality before services are provided to the patient. Obtains contact information for patients brought by ambulance or other transportation.

Chronic Disease Mgmt Clinic/Rural Health Clinics/Family Medicine Center-GME:

Performs standard clerical duties, including sorting of mail, answering telephones, returning calls, maintaining files, copying and mailing correspondence. Able to operate all office equipment. May also be responsible for taking meeting minutes and scheduling appointments for the department. May order supplies and handle related paperwork. Schedules appointments following department procedures. Answers telephone, screens and refers calls, takes messages. Responds to routine requests for information. Greets patients and visitors in a prompt, courteous and helpful manner. Checks-in patients, verifies and updates necessary information in the medical record or computer system. Ensures proper client intake at front desk. May be required to research information needed to complete billing process. May be assigned to key charge information into computer systems for billing purposes. May determine client payment status, i.e., Medi-Cal, Insurance, Cash, etc. When necessary makes referral to benefit counselor. May collect co-pays, deductibles, etc. Provides receipts as required. May be responsible to prepare bank deposits. May be assigned to complete charge postings. May obtain, maintain and file medical record, coordinate lab work, physicians reports, x-rays, etc. Distributes medical reports as assigned. Enters appropriate information into medical record, adhering to medical record guidelines. Ensures that all documents have been reviewed and filed in medical record according to procedure. May be responsible for gathering data, completing reports or forms for the department. May be responsible for ordering labs. May be responsible for entering MD orders in department computer system. May be assigned to perform document preparation and scanning into EDM and notes on document when scanned. Releases patient information per appropriately authorized requests. May be responsible to provide a few back office duties such as: escorting patient to exam room, making sure all paperwork is complete. Checks messages and responds in a timely manner. Responsible for checking fax machines and routes appropriately. Rural Health Clinics may be assigned to work on HEDIS (Healthcare Effectiveness Data and Information Set) tracking quality measures working with Care Coordinators.

Pre-Arrival:

Accurately completes pre-registration for patient presenting for services. Contacts patient when necessary to obtain any additional information needed to complete pre-registration prior to scheduled services. Contacts patient one business day prior to scheduled service to confirm appointment. Explains to patient any special preparations required for service being performed. Collects copayment or patient responsibility over the phone. If unable to collect it, informs patient of any copayments or financial responsibility due at the time of service. Pre-registers patients for their procedures as needed and verify their insurance coverage either online or by phone.

Imaging Center:

Modifies orders in system and cancels exams appropriately, including documenting reasons in Imaging information system. Notifies nursing upon rescheduling or canceling exam. Checks in patients, verifies and updates necessary information in the medical record. Ensures proper client intake at front desk. Obtains necessary release signatures for any Imaged records. Assures that documents are appropriately identified prior to being scanned into the applicable imaging system.

Centralized Scheduling:

Schedules all procedures for patients in a timely manner and following office policy. Accurately enters information about each procedure into the scheduling system including any special information about the patient i.e., allergies, wheelchair, translator etc. Obtains all information from physician's office necessary to schedule and provide services to the patient. Information needed includes but not limited to patient chart information, labs and proper reason for exam. Demographic information for patient as well as insurance information must also be obtained.

Additional:

If assigned to Evening shift, may be assigned to distribute the surgery schedule following procedure.

If assigned to Night shift, may be assigned to complete the nightly census audit following procedure.

Demonstrates the knowledge and skills necessary to provide care and services appropriate to the population served on the assigned unit or work area.

Performs duties as assigned.

Pay Range

$20.00 -$30.00

If you want to use your talents alongside people who face each day with courage and purpose, in an environment that empowers you to do your absolute best, this is where you belong.