Access Management Rep | Pre-Admission Specialist

Access Management Rep | Pre-Admission Specialist

Fallbrook, CA $46,499 - $53,399 a year

Job Type: Full Time

Position Overview

This role involves interviewing patients or their representatives to gather essential personal and financial details. You will prepare patient records and ensure all necessary demographic information is accurately communicated to relevant departments.

Key Responsibilities

• Maintain a safe and clean work environment, adhering to unit safety and infection control protocols.
• Collect, verify, and complete patient demographic, employer, financial, emergency contact, insurance, subscriber, and case-specific information such as referring physician and diagnosis before the patient's scheduled arrival.
• Coordinate with the Operating Room Department to confirm cancellations and additions for the next day's surgery schedule. Secure all scheduled services for inpatient surgery, same-day surgery, and outpatient ancillary services from scheduling.
• Verify insurance eligibility, benefits, and authorizations prior to service dates. Inform patients of any financial responsibilities before admission and attempt to collect liabilities ahead of service.
• Obtain prompt and accurate insurance eligibility through various methods including online portals, direct telephone contact, or electronic data interchange.
• Pre-admit surgical add-ons in registration and patient accounting systems, including detailed patient notes.
• Provide surgery cost estimates to patients upon request.
• Explain financial obligations to patients and collect cash deposits by phone prior to service when possible. Post payments upon receipt.
• Communicate payment policies clearly when patient liabilities exceed $1,000.
• Coordinate patient information with Express Admit nurses or Bed Placement representatives for non-surgical acute care admissions.
• Perform special duties as assigned to support departmental needs.
• Maintain excellent interpersonal skills when interacting with coworkers, staff, patients, physicians, and the public.

Qualifications

• Minimum of one year experience in healthcare insurance verification, billing, or third-party authorization.
• Typing proficiency of at least 35 words per minute.
• Strong knowledge of various third-party payers and their authorization requirements.
• Preferred experience with data entry/CRT and familiarity with medical terminology.

Education

• High school diploma or equivalent required.

All new hires must successfully complete a physical evaluation, urine drug screening, and pre-employment background checks prior to starting work.

This position is located in a regional healthcare setting within the Pacific Southwest region of the United States.