Patient Access Representative, Full Time, HVL Rapid Care

Patient Access Representative (Clinic)

Performs a variety of specialized clerical duties relating to the pre-admission and admission of all patients and the compilation of necessary demographic and financial data for various hospital departments and functions. This position is represented by RCHEA.

Line of Authority: Patient Registration AssociateClinic Manager/Practice Administrator/Admitting Supervisor

Education and Qualifications:

• High School graduate or GED equivalent
• Able to file alphabetically
• Able to organize and maintain good follow-up
• Above average computer skills, written and verbal communication skills
• Knowledge of insurance and billing procedures
• Knowledge of medical terminology
• Working knowledge of basic office and clerical skills

Physical Requirements/Work Environment/Use of Senses and Communications Skills:

• The physical demands and work environment characteristics described here are representative of those an employee typically encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the key responsibilities and essential functions.
• Employee must conform with all HIPAA and other confidentiality regulations as required by the job, department, or hospital.
• This job requires frequent bending, squatting, kneeling, climbing, reaching above shoulders, sitting, walking inclines and declines, standing, talking, hearing, and performing repetitive hand motions. Vision requirements include close vision and the ability to adjust focus. The employee will occasionally lift boxes and/or supplies weighing up to 25 pounds. The employee must demonstrate lifting a 25-pound box from the floor.
• Category 3 for potential exposure to blood/body fluids. Does not require the performance of procedures or other tasks in the work routine that involve exposure to blood, body fluids or tissues, and the assisting in cases of emergency medical care or first aid is not a requirement of employment. Tasks that involve handling of implements or utensils, use of the public or shared bathroom facilities, telephones, and personal contacts such as handshaking, are all considered Category 3 tasks.

Job Roles:

• Answers all telephone inquiries in a timely, courteous and professional manner. Attends to administrative needs of patient/family during hospital stay. Obtains proper signatures on Conditions of Admissions, Patient Rights Acknowledgement, Medicare Screening Form, Important Message from Medicare Notice, etc. Completes eligibility, verification, estimate, and collection activities on Medeanylitics on all accounts as needed.
• Confirms commercial insurance coverage and benefits for all inpatients and outpatient surgery services.
• Confirms insurance on all Worker's Compensation Claims.
• Consistently performs special projects/assignment in a careful and thorough manner and in accordance with identified goals and instructions from the department supervisor or department director.
• Covers PBX desk when necessary.
• Greets patients in appropriate manner and requests them to sign in.
• Interprets and verifies insurance coverage to include Medicare, Medi-Cal, CMSP and commercial insurance programs.
• Interviews patient or his/her representative and obtains complete and accurate personal, demographic and financial information necessary for hospital admission/registration.
• Maintains and meets expectations on time for all competencies, license, certifications and education requirements as outlined by local administration, Adventist Health (AH), The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS), and all other regulatory agencies.
• Maintains established department policies, procedures, objectives, quality assurance, safety, environmental and infection control standards.
• Notes any financial information needed by the Patient Accounting Office using the prescribed account note methodology.
• Obtains signature of patient or responsible party on required forms. Verbal permission obtained when necessary and note on forms with two witnesses.
• Verifies completed registration through AETS program and Qcode report. Willingly performs other duties and innovations as assigned.