Patient Access Services Rep - Per Diem Evenings

Job Summary

Registers patients in a professional, courteous, and timely manner, ensuring a positive guest experience. Conducts patient/guarantor interviews, explains hospital policies, financial responsibilities, and patient rights. Accurately collects and enters demographic and financial data, identifies payor sources, and secures required authorizations. Handles routine inquiries and supports efficient patient access and revenue cycle processes.

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 their health or safety of themselves or others.

• Interviews and registers patients in a courteous manner and in compliance with the hospital's policies and procedures.
• Ensures "EMTALA" rules and regulations are strictly adhered to when registering patients through the emergency department
• Enters required data in the system, with emphasis on accuracy of demographic data and financial information, thus ensuring appropriate revenue routing
• Validates existing data related to prior registration and updating appropriately in the system.
• Enters all patient demographic and financial information with an accuracy level of 97%.
• Scan all necessary insurance information including insurance cards, personal ID, driver's license, etc…
• Responsible for follow up on registrations performed outside of the primary registration area (ie. Conditions of Admission, Advance Directive, demographics).
• Ensures that Advance Directives are executed when applicable.
• Obtains insurance information and if applicable accident/work comp information. Verifies information, updates account and face sheets to accurately reflect patient's insurance/coverage information and collectability of accounts.
• Identifies the appropriate payor source (plan ID, financial class, etc) and enters the information in the system.
• Ensures that all pre-certifications/authorizations are completed within the specified time frames as mandated by the payor's payment authorization protocols.
• Ensures documentation of financial activity.
• Requests and collects deposits, deductibles, copays and payment for non-covered services to reduce bad debt expense. Provides 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 protocol
• Verifies all patient insurance and confirms patient has adequate coverage.
• Completes financial packet to assess patient's ability to pay.
• Establishes financial arrangement based on hospital's collection policy.
• Provides the patient with summarization forms and all information explaining supplemental billing for professional fees.
• Identifies all Medi-Cal and Medicare patients through the appropriate eligibility system and through completion of the Medicare questionnaire (MSP).
• Completes the "Advanced Beneficiary Notification" and collects payments for services not medically necessary as stipulated by the Federal Health Care Financing Administration.
• Records comments in the system to permit timely and accurate follow up.
• Ensures patient sensitive issues are handled appropriately and timely.
• Assists admitting supervisor/director where applicable.
• Obtains proper room assignment according to the patient type and diagnosis from Admitting nurse/nursing supervisor/floor where applicable.
• Distributes face sheets or electronic data to appropriate departments in a timely manner.
• Updates census with floors for proper patient placement, where applicable.
• Refers problem accounts or accounts that need follow up to financial counselors and/or management team.
• Maintains a professional atmosphere in the hospital at all times.
• Always answers telephone in a prompt, courteous manner.
• Adjusts to changes in department schedule when reasonably requested based on census.
• Fills in for emergency situations as requested.
• Switches to a different shift other than the normal working shift when required.
• Respects patient's right to privacy as mandated by the Patient's Bill of Rights
• Responds to requests in a friendly, cooperative manner, as determined by feedback from guests, the supervisor and manager.
• Operates as a team with co-workers by approaching relationships in a manner which avoids antagonism and reduces conflict.
• Attends and participates in meetings and is responsible for all information communicated at meetings.
• Assists all patients, family members, physicians, visitors and employees in a professional and courteous manner.
• Assists in maintaining an atmosphere of cooperation with other departments and allied professionals.
• Demonstrates the ability to participate in and/or implement team decisions.
• Actively participates in and encourages actions that promote good public relations with patient's families, visitors, and the community.
• Shares information on a "need to know" basis, adhering to all HIPAA standards.
• All other job duties as assigned.

EXPERIENCE/QUALIFICATIONS:

• Minimum 2 years of experience in healthcare, insurance or related experience.
• Previous work experience in an inpatient or outpatient admissions setting or physician's office, preferred.
• Knowledge / experience in patient accounting or with an insurance payor preferred.
• Knowledge of medical terminology
• Strong interpersonal, written and oral communication skills for interacting with patients, payers, physicians and other customers.
• Demonstrated ability to work well as a team player and independently.
• Computer literacy

EDUCATION:

• High School graduate or equivalent
• Some college and/or medical terminology coursework preferred.

LICENSURES/CERTIFICATION:

• Must successfully complete and maintain LA City Fire Card certification at the time of hire or within the first 30 days of employment
• Must successfully complete and maintain certification for Mgmt of Assaultive Behavior (ex. CPI- Non-violent Crisis Intervention) within 30 days of employment.

MUST HAVES:

All required licensures, certifications, mandatory education, along with annual occupational health screenings must be completed prior to the expiration date or by the end of the month in which they are due. Reference the Educational Requirements: Must Haves, Mandatory and Unit Based policy (in electronic policy management system) for the specific requirements for this position.