Access Service Representative - Admitting/ED - Coronado Hospital - Variable Shift - Full Time

Job Title

Performs out-patient registration process for ancillary area and promotes premier customer service.

Patient Access Services (PAS) department coordinates all phases of the revenue cycle from pre-registration up to and including departures, referrals, and denial management. This role performs pre-registration/registration functions prior to or at the time of the visit date to initiate a medical record and bill, obtain demographic, visit, and financial information. Insurance benefits are confirmed with online verification systems or telephone inquiries. All applicable PAS ancillary forms are generated, completed and distributed for each visit and appropriate information is secured for referrals and authorizations required from insurances. Coordinates the ancillary area to promote patient safety, incoming ancillary department phone calls and monitoring of the ancillary waiting area.

Required Qualifications

• H.S. Diploma or Equivalent

Other Qualification Requirements

• HFMA Certification Preferred.

Essential Functions

• Cash collectionNotification to scheduled patients with any self-pay liability at least 1 day prior to procedure. If patient is unable to pay requested amount, negotiate a portion.Request payment of co-pay, deductible, or coinsurance portion due prior to the service.Receive funds, issue receipt and update Centricity visit comment to assure proper crediting and auditing of receipts.Security is adequately provided for all funds and receipts at all times.Ancillary deposits are prepared, verified and reconciled according to department and hospital standards.Able to competently use the self-pay price quote system.
• Completes insurance verification and authorizationsReview all scheduled patient accounts to ensure pre-verification prior to the procedure.Use Centricity Business Visit Manager to review all pre-scheduled radiology procedures. Complete Visit Manager checklist as appropriate for scheduled radiology accounts.Review insurance coverage information in Centricity Business. Use standard Coordination of Benefits standards to prioritize billing order for insurance plans.Review insurance eligibility and benefits in MPV.Verify all required hard copy authorizations are scanned in.Identify co-pay amount and any other patient liability including coinsurance and deductible amounts.Updated Centricity visit comments with expected patient out of pocket.Complies with all rules and regulations governing Medicare and Medi-Cal billing as well as assures all billing compliance standards are met.Review all hold bills and work as appropriate.
• Department operationsAnswers incoming ancillary phone lines in a respectful manner.Ability to handle incoming call volume and transfer accordingly.Ability to review ancillary computer systems to assist with monitoring patient flow and wait times.Patient/families are always informed of delays, including reason for delay.Monitors ancillary waiting area and updates provided to patients as needed.Demonstrates teamwork and cooperation specifically with the ancillary area being supported through positive communication.Downtime is used productively.Prioritizes effectively and keeps management informed of backlogs.
• Patient data managementPopulate all demographic screens for new and established patients to comply with Sharp Registration Standards.Secure patient signature on address attestation.Deliver the Notice of Privacy Practices (NPP) and the Patient Rights to patients new to Sharp Healthcare. Update the registration field related to NPP.Obtain accident related information and update appropriate visit fields with known details.Enter appropriate diagnosis with no abbreviations.Secure Primary Care Provider information.
• Patient safetyCoordinate check-in of all scheduled and non-scheduled patients to the ancillary area to ensure patient safety.Authenticate and/or enroll patient in Patient Secure palm scanning. Follow established guidelines such as scripting and picture identification for enrollment/authentication.In absence of Patient Secure, use at least two patient identifiers to confirm patient identity.Review of physician order to facilitate check-in.All efforts are made to appropriately prioritize scheduled patients.Notify DUPREG when potential duplicate registrations are identified.
• RegulatoryUsing scripting, review Conditions of Admission (COA) with patients, secure signature on COA and update the COA field.COA fields are clearly and accurately completed on form.For Medicare patients, complete Medicare Secondary Payer (MSP) questionnaire.
• OnBaseUse of OnBase to review physician orders.Obtain and scan all necessary access service related documents (i.e. physician orders, hard copy authorizations, ID cards and insurance cards).All scans are expected to be clear and associated with the correct identifier.All scans are located on the appropriate account associated with the document.

Knowledge, Skills, and Abilities

• Ability to communicate/discuss personal and financial matters with patients and/or their representatives.
• Ability to document effectively and concisely.
• Ability to communicate effectively both verbally and in writing.
• Ability to function well in demanding/stressful environments.

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.