Access Service Representative - SRN Float Pool - Sharp HealthCare - Variable Shift - Per Diem

What You Will Do Coordinates all registration functions necessary to ensure the processing of a clean claim including but not limited to obtaining and processing patient demographics, visit and financial information in a manner that facilitate maximum financial reimbursement and promotes premier customer service. This role utilizes Patient Secure to identify the accurate patient medical record while adhering to EMTALA regulations and performs face-to-face interviews directly with patients and/or their designated representatives. Accurate identification and delivery of regulatory documents and securing patient financial responsibility is a key responsibility. Required Qualifications 2 Years experience in a business service setting. Must have experience communicating effectively both verbally and in writing professionally. Preferred Qualifications H.S. Diploma or Equivalent Experience communicating and discussing personal and financial matters with patients and/or their representatives is preferred. HFMA certifications preferred. Essential Functions Collections Follow department guidelines for providing patient with estimate letter. Request payment of co-pay, deductible, estimated out of pocket or good‑faith deposit in a manner specified in department and hospital policies. If patient unable to pay requested amount, negotiate some portion. Receive and process funds, print and file receipt, and update Centricity visit comments. Secure all funds and receipts in accordance with department standard. Insurance/Plan Selection After medical screening (ER settings), obtain health benefit coverage including possible accident related coverage. Input all insurance coverage information into Centricity Insurance Verification (IF). If patient unable to provide insurance, search for potential coverage through MCA for SRS/SCMG and MPV (or Portal) for potential Medicare or Medi-Cal. Use Coordination of Benefits (COB) standards to prioritize billing order of insurance plans. Medicare patients – Medicare Secondary Payer (MSP) questionnaire is completed. Validate insurance eligibility electronically (e.g., MPV, Experian) when applicable. Validate health benefit coverage including possible accident related coverage. Validate and identify the Primary Medical Group on Health Maintenance Organizations (HMO) patients. Notify clinical staff, including physician, on patients that are out-of-network. Follow process to estimate patient out of pocket based upon department guidelines and collect patient financial responsibility. Communicate to patient and leadership when unusually high out of pocket, unusually limited coverage, and/or if insurance is out of network (OON) following the guidelines established for the facility. Initiate interview on unfunded/underfunded patients. Input financial screening results into Pointcare fields as appropriate and provide patient with potential coverage options. Complete the process by recording the outcome through X8 function. Complete HPE (Hospital Presumptive Eligibility) process when appropriate. Document in Centricity visit comments if patient declined or completed financial screening. Follow self-pay process (aka toolkit) to discuss the Sharp out of pocket expectation. Customer Service Use AIDET, key words at key times, On-Stage Behavior and support 5-star results on patient satisfaction. Communicates effectively both orally and in writing sufficient to perform the essential job functions. Use tact and empathy in working with customers under stressful situations and with frequent interruptions. Avoid abbreviations when communicating to patient. Adapt and protect patient privacy as needed (i.e., lowering voice, using face sheets vs. verbal interviews). Practice good interpersonal and communication skills and ability to work well with others contributing to a team environment. Practice a positive and constructive attitude at all times. Negotiate with others, handles minor complaints by settling disputes, grievances and conflicts. Perform service recovery when The Sharp Experience does not go right in accordance to the department standards and Sharp's Behavior Standard Service Recovery. Identify solutions to issues not covered by verbal or written instructions. Additional Responsibilities Demonstrates initiative and teamwork. Prioritize job responsibilities effectively. Keep management informed of backlogs or slow volume. Round on patients when volumes are low as identified by your department. Patients are processed timely based upon depart standards such as quality audits, time, and production measurements. Offer to assist others and asks for assistance in completing of assignments, as needed. Inform patient/families of admission delays and cause if known or allowed. Promotes a team approach in completion of department duties. Contributes to department production by maintaining expected level of productivity designated by the department. Other duties as directed by Leadership, provide ongoing support of department and hospital needs as assigned. When applicable, collect patient valuables according to policy and secure them by entering into log and dropping into department safe. Follow hospital policy to release valuables. When applicable, update Patient Type, Bed Placement, Accommodation Code, Attending Physician. ED Unit Clerk responsibilities as described in original description. Customer Information Center duties (SCO only) as described. Patient registration duties: Authenticate and enroll patient at workstations where Patient Secure palm scanner is available. Update regulatory fields in demographic data with patient choices on regulatory forms. Secure patient signature on address attestation. Follow defined documentation process with homeless patient. Observe EMTALA regulations related to financial information disclosures. Use scripting to review Conditions of Admission and update Centricity fields accordingly. Follow guidelines for delivery of Medicare Outpatient Observation (MOON) and Outpatient Observation Notice (OON) to all patients admitted in an Observation status. Request and input Primary Care Provider (PCP) information and initiate Health Information Exchange (HIE) process as appropriate. In areas performing post regulatory review, address outstanding alerts in the Centricity Alerts Manager based upon your department's workflow. Secure necessary Access Service related documents and scan to correct form/identifier. Knowledge, Skills, and Abilities Knowledge of Medical Terminology. Knowledge of insurances, billing and collections guidelines/criteria. Knowledge of Local, State, and Federal regulations governing registration/billing activities including Joint Commission, Title XXII, Medicare and Medi-Cal regulations. Knowledge of ICD‑10, CPT, and/or RVS coding. Knowledge of Medicare Important Message, Medicare Secondary Payor, Tricare Third Party Liability; Auto Accident and Work Comp, Medicare/Outpatient Observation Notice. Equal Opportunity Statement Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class. #J-18808-Ljbffr 300 Sharp HealthCare