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PT ACCESS REPRESENTATIVE (83454): CHW-Mark Twain Saint Joseph's Hospital

Job ID83454
Company NameCHW-Mark Twain Saint Joseph's Hospital
Job CategoryClerical/Administrative; Healthcare
LocationSan Andreas, CA
Position TypeFull-Time, Employee
ExperienceUnspecified
Date PostedOctober 20, 2009 (Reposted Nov 18)






PT ACCESS REPRESENTATIVE (83454)


FACILITY INFORMATION

Do you love the outdoors?
Do you love wide-open spaces and the mountains?
Do you love snow skiing, water skiing, boating, hiking, backpacking and all other recreational activities?
Do you love wine tasting and the arts?
Do you want to live where others come to vacation?

Then come join the team at Mark Twain St. Joseph's Hospital. We're located in San Andreas, California in the beautiful foothills of the Sierra Nevadas. Yet, we are within an easy drive to Sacramento, Stockton, and Modesto and just three hours away is the ocean. You can ski in the morning and swim in the ocean in the late afternoon.

If you want to work for a hospital with a family atmosphere where employees truly care about one another than this is the place for you.

To learn more about beautiful Calaveras County, go to the Visitor's Center's web page at gocalaveras.com.



POSITION REQUIREMENTS

Standard Hours: 8-hour various shifts, weekends/holidays required.

POSITION REQUIRMENTS

Skills -
•Demonstrates skills associated with Admitting and answering telephones
•Must have proficient typing skills.
•Demonstrates ability to speak clearly.
•Familiar with medical terminology.
•Good skills in spelling, grammar and dealing with the public
Experience -
•Computer experience required
•Previous registration experience preferred
•One year medical office preferred
Work Conditions -
•Inside work
•Frequent interruptions
• Working on computer terminal
Physical Requirements -
•Ability to sit or stand in one place for a long period of time
•Lifting up to 10 pounds over shoulders
•Bending and stooping
•Walking in Patient care areas.

JOB DUTIES

1.Ensures complete, accurate and timely entry of insurance information into the Allegra system, either at the time of service or during pre-registration/pre-admission.
2.Collects, enters and completes corrections of required data into the Allegra system with emphasis on accuracy of demographic and financial information in order to ensure appropriate reimbursement for services for inpatients and outpatients at the time of service or during preregistration/preadmission.
3.Verifies insurance benefits on all assigned scheduled admissions and outpatient services above the facility-defined $ threshold, at least 3 days prior to date of service when possible, by using electronic verification systems to determine the level of insurance coverage and documents accurately in the system.
4.Verifies insurance benefits on all urgent/emergent admits within 24 hours of service (or next business day) by using electronic systems.
5.Obtains insurance verification, referral, authorization and pre-certification, and documents this information into the system and submits notices of admission, where necessary.
6.Verifies patient liabilities with payers during pre-registration, where possible.
7.Determines patient financial responsibilities at time of service and collects co-payments, deductibles, co-insurance or deposit amounts in accordance with system's cash control policies at the time of service.
8.Obtains PCP approvals, where appropriate, clarifying division of financial responsibility and documenting in the system.
9.Verifies medical necessity check has been completed for outpatient services. If not completed and only where appropriate, uses technology tool to complete medical necessity check; or else notifies patient that ABN will need to be signed.
10.Escalates accounts appropriately to appropriate personnel, based on outcomes of the verification process.
11.Interviews self-pay patients to identify those who may be eligible for government aid and directs them, as appropriate, to appropriate resource for assistance, either before or at the time of service.
12.Explains the CHW Payment Assistance program fully, and directs them for further assistance, as necessary, either before or at the time of service.
13.Identifies appropriate forms for patient/guarantor signature and obtains these signatures.
14.Escalates accounts that do not meet financial clearance standards quickly for Patient Access leadership attention, typically prior to the time of service.
15.Acts as resource to other hospital departments on insurance benefits and requirements and collaborates with other departments, as needed, to ensure proper compliance with third party payer requirements.
16.Complies with HIPAA, PHI and its implications, ABN, MSP, EMTALA, etc and other regulations which affect the registration process.
17.Continues self-education regarding payer requirements and third party regulations under the guidance and assistance of department management.
18.Performs all necessary duties associated with downtime procedure.
19.Performs various detailed duties relating to communication, including responding to all alarms and codes appropriately.
20.Performs specific duties associated with the paging system.
21.Answers phone calls with professionalism.
22.Performs clerical duties associated with the department.
23.Other duties as assigned.

POSITION SUMMARY

Facilitates the patient admission flow, including activities such as: patient identification, identification of accurate demographic and insurance information, and collection of required signatures and documents. This position requires the full understanding and active participation in fulfilling the Mission of the Organization. It is expected that the employee demonstrate behavior consistent with the Core Values. The employee shall support the Organization's strategic plan and the goals and direction of the Performance Improvement Plan (PIP).





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