Valley Presbyterian: Patient Access Services Representative Ii

Employment Status:Full Time (72-80 Hours Per Pay Period)Job Category:Administrative & ProfessionalJOB SUMMARY:Ability to perform accurately the duties and responsibilities of PAS Level I.

In addition, the ability to schedule and pre-register patients in a pleasant, professional, accurate and timely manner.

Conducts patient/guarantor interviews, explains hospital policies, financial responsibilities, and patient bill of rights.

Handles all routine patient inquiries related to the pre-registration, registration, and scheduling process.

Ensures all necessary demographic and financial data is obtained and entered in Meditech with accuracy.

Ensures accounts are thoroughly documented.

Identifies payor source for routing of revenue generated during the patient stay.

Ensures that any pre-certification and/or authorization is obtained for surgeries and other scheduled procedures to meet individual payor payment authorization protocols.EXPERIENCE/QUALIFICATIONS:Minimum two (2) years as Patient Access Services RepresentativeComputer literacyExcellent communication and public relations skillsKnowledge of medical terminologyBilingual Preferred (Spanish)EDUCATION:High School graduate or equivalentSome college and/or Certified Patient Account Technician certification, medical terminology course, management coursesLICENSURES/CERTIFICATION:Must successfully complete and maintain LA City Fire Card certification at the time of hire or within the first 30 days of employmentMust successfully complete and maintain certification for Managing of Aggressive Behavior within 30 days of employment.DUTIES AND RESPONSIBILITIES ( These are the essential job functions for this position.

The essential functions of this job include, but may not be limited to those listed in this job description.

Employees hired for this position must be able to perform the essential function of this job without imposing significant risk of substantial harm to the health or safety of themselves or others) :Assists in maintaining staff schedule to ensure all registration areas are staffed appropriately.Pre-registers all elective/ scheduled procedures and services.Schedules patients for ancillary services in Meditech Community Wide Scheduling (CWS) module.Ensures scheduling accuracy in accordance to department and category mnemonics.Ensures physician order is in accordance to hospital regulations.Obtains financial and demographic data necessary to perform the scheduling, registration or pre-registration function.Obtains insurance information and if applicable accident/work comp information.Obtains all billable insurance, verifies benefits and eligibility for services provided.Ensures pre-certification and authorizations are obtained in accordance with the payor’s payment authorization protocol.Ensures authorization is valid and appropriate based on procedure and patient admission status, ie inpatient, outpatient or observation.Obtains Letter of Agreement authorization for patients capitated to other facilities.Ensures financial clearance and calculation of patient financial responsibility based on payer and type of services provided.Negotiates payment for all private pay patients and under insured patients according to the hospital’s collection policy.Provides the patient with summarization forms and all information explaining supplemental billing for professional fees.Collects deposits, deductibles, copays and payment for non-covered services to reduce bad debt expense.Provides patient with payment options in the form of cash, check, credit card, or other bank financing where applicable.Utilizes tools available to ensure compliance with payor’s payment authorization protocolRefers problem accounts or accounts that need follow up to Supervisor or Manager.Identifies the appropriate payor source (plan ID, financial class, etc) and enters the information in the system.Enters all patient demographic and financial information with an accuracy level of 97%.Records comments in the system to permit timely and accurate follow up.Conducts phone interview for purpose of scheduling, pre-registration or registration in a professional and courteous mannerAccuracy in service and accommodation codes based on patient type.Provides transportation escort/service for patient as needed.Ensures patient sensitive issues are handled appropriately and timely.Scans all necessary information and documents including insurance cards, personal ID, driver’s license, etc.In appropriate Form ID.Responsible for follow up on registrations performed outside of the primary registration/scheduling area (ie.

Conditions of Admission, Advance Directive, demographics).Respects patient’s right to privacy as mandated by the Patient’s bill of rightsEnsures “EMTALA” rules and regulations are strictly adhered to when registering patients through the emergency departmentUpdates census with floors for proper patient placement, where applicable.Always answers telephone in a prompt, and courteous manner.Assists in maintaining an atmosphere of cooperation with other departments and allied professionals.Demonstrates respect and cooperation in all staff relationships, and a genuine willingness to prevent or resolve inter-personal conflicts.Demonstrates the ability to participate in and/or implement team decisions.Flexibility to float in all areas of Patient Access Services as needed.Attends and participates in meetings and is responsible for all information communicated at meetings.Shares information on a “need to know” basis, adhering to all HIPAA standards.Assists Patient Access Supervisor/Manager where applicable.All other job duties as assigned.The following job accountabilities are not unique to this particular job but are common to all jobs at VPH:Complies with VPH policies and procedures on customer satisfaction and service excellence.

Demonstrates professionalism and cultural sensitivity in coordinating activities and communicating with all customers, peers, and the community at large.

Conducts self in a professional, respectful and courteous manner during all interactions.

Works effectively and collaboratively with others toward common goals.Communicates accurately, honestly, supportively and in a timely manner with department and interdepartmental team members.Demonstrates effective business writing and oral communication skills, handwriting is clear and legible.Participates in operational aspects of the department, and maintains/participates in performance improvement activities within the department.Participates in all departmental specific training, Environment of Care (injury/illness prevention, fire/life safety, hazardous materials, emergency preparedness, utilities management, medical equipment management, safety and security management), infection control (standard precautions, TB Exposure Control Plan, Bloodborne Pathogen Exposure Control Plan).Demonstrates knowledge of and follows safety practices.

Understands the importance of safety, including patient safety in the work place.

Maintains a safe environment for self and others.Actively participates in the Patient Safety Program, including event reporting.

Identifies sentinel events/near misses and responds per defined organization processes.

Participates in education activities and process implementation.

Demonstrates advocacy for the patient/customer and appropriately acknowledges patients, customers and visitors.The above statements reflect the essential functions considered necessary to describe the principle content of the job.

They are not intended to be a complete statement of all work requirements or duties that may be inherent in the job.WORK ENVIRONMENT:Primarily an inside building/office environment, well lighted and ventilated, which may consist of multiple treatment and/or work sites.Fast and continuous work pace with variable workload.Frequent contact with staff and public under a variety of circumstances.

Requires ability to communicate clearly (in English) verbally and in writing for effective communication with other staff members, physicians, vendors, community members, patients and patient families, employees and applicants of all socio-economic levels from a diverse cultural and ethnic population.Subject to many interruptions from multiple calls and inquiries and potentially emotional situations involving accidents, injuries, illness and/or death.Handles emergency/crisis situations in accordance with Hospital policy.Answers phones or pages; may carry a beeper/pager, and/or use a two-way radio.Occasional travel may be required.Potential risk of exposure to hazards from chemicals (toxic and non-toxic), flammable materials, gas or electrical or radiant energy or equipment with/without moving parts.PHYSICAL DEMANDS: Continuous: 66 to 100% of time Frequent: 33 to 65% of time Occasional: 0 to 32% of timeFrequent/continuous sitting with occasional, intermittent standing/walking.Continuous use of bilateral upper extremities in fine motor activities requiring fingering, grasping, and forward reaching between waist and chest level.Occasional/intermittent reaching at or above shoulder level.Occasional/intermittent bending, squatting, kneeling, pushing/pulling, twisting and climbing.Occasional/intermittent lifting and carrying objects/equipment weighing up to 25 pounds.Continuous use of near vision, hearing and verbal communication skills in handling telephone calls, interacting with customers and co-workers and performing job duties.

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