Patient Access Representative - Santa Monica

Patient Access Representative

As the Patient Access Representative, you will be responsible for:

• Pre-registers, pre-admits, and admits patients by telephone and/or in person
• Collection of accurate demographic information, review and interpretation of insurance benefits
• Obtaining prior authorizations, cash collections, interaction with public assistance programs (i.e. Medi-Cal, CCS)
• Implementation of Medicare requirements, interaction with physicians/office personnel as well as other hospital personnel (i.e., SDA, OPSU, nursing units)
• Referral of appropriate cases to other internal and external sources to assist patients with discharge/post-hospital care
• Interacting with hospital departments such as Utilization Review and Patient Business Services to ensure correct and timely reimbursement

We're seeking an exceptional, self-directed professional with:

• Knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS programs, out-of-state Medicaid, or other sponsoring agencies
• Knowledge in the functional operations of third party payers and utilization review agencies to expeditiously coordinate follow-up
• Working knowledge of third party payer verification terminology
• Working knowledge of medical terminology to sufficiently identify various procedures to obtain optimum benefit information and
• Ability to accurately and completely process payments and cash receipts
• Ability to write concise, grammatically correct reports and correspondence
• Ability to type 55 words per minute (WPM)
• Proficient in basic math
• Proficient in Microsoft Office Suite, specifically Excel, Word, and Outlook

Note: May be subject to test on qualifying skills