Financial Rep Access Dept

Patient Access Representative

Serves as the first contact for patients and families regarding funding sources for inpatient and outpatient services. Responsible for the day to day activities of obtaining funding for patients in the statuses of scheduling, pre-registration, registration, or post registration as assigned. Screens all admissions on a daily basis and educates referring physicians offices, patients and their families on hospital policy and procedures regarding various methods of payment source for services rendered. This may include advising applicable admits of pre-payment deposits and monthly payment arrangements. Obtains and documents information that appropriately designates current funding information and/or provides information on available funding sources if the patient/family does not have current sources. Works in collaboration with all departments and units in the revenue cycle to appropriately communicate issues and/or barriers, and to formulate work plans for resolution. Obtains appropriate up front collection on all self pay accounts as well as co-pays, deductibles, and co-insurance as identified in information provided by the patient's insurance card or through the eligibility and verification process. Screen the patient for possible other 3rd party and charity eligibility and keep up-to-date on admission/business office insurance procedures. Adept at utilizing payer resources and web sites to accurately explore and assess eligibility and successfully initiate referrals for MediCal/CMS/CCS. Appropriately administers the Palomar Health Financial Assistance Policy and Procedures to determine if the patient is eligible for discounted prices for services or is eligible for charity care designation. Well versed in policy and procedure that pertains to AB774 and is able to assist the patient/family in determining if they qualify based on federal poverty guidelines. Responsible for careful financial evaluation of all admissions, taking appropriate steps that are most beneficial to the hospital, while giving the proper level of consideration to the patient. Must be firm and decisive, yet courteous, tactful, considerate and show concern and empathy for the patient/family under often stressful situations. Must be keen, alert and have the ability to effectively communicate with people from various education backgrounds. Must have the knowledge and confidence to make decisions regarding methods of payment and have the ability to work with frequent interruptions. Speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position. Knowledge of standard office equipment (i.e., calculator, fax, photocopier) and personal computer and computer software skills (i.e., MS Windows, Excel, Access, Word, Powerpoint, internet, e-mail). Windows computer skills including proficient use of keyboarding, use of mouse or keys for functions such as selecting items, use of drop down menus, scroll bars, opening folders, copying and similar operations required upon employment or within the 1st two weeks of employment to perform the essential functions of the job. Performs other duties as assigned. Follows Palomar Health rules, policies, procedures, applicable laws and standards. Carries out the mission, vision, and quality commitment of Palomar Health.

Job Requirements

Minimum Education: High School Diploma and/or combination of education and experience

Preferred Education: High School Diploma and/or combination of education and experience plus 1 year healthcare-related experience or basic college/medical coursework to learn medical terminology

Minimum Experience: 2 years Patient Access and/or Patient Financial Services experience assisting patients with insurance and government funded programs

Preferred Experience: 3+ years Patient Access and Patient Financial Services experience assisting patients with insurance and government funded programs, including experience related to billing and payment of government funded health plans. Bilingual (Spanish)

Required Certification: Not Applicable

Preferred Certification: Certified Healthcare Access Associate (NAHAM)

Required License: Not Applicable

Preferred License: Not Applicable

Current employees are not eligible for hiring incentives. We are an equal opportunity employer and do not discriminate against applicants or employees based on race, color, gender, religion, creed, national origin, ancestry, age, disability, sexual orientation, marital status or any other characteristic protected by law.