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Patient Access Rep Ii Admitting Full Time Days
4 months ago
**Desert Regional Medical Center** is a 385 bed acute-care hospital classified as a stroke receiving center and level 2 trauma facility with an innovative, patient centered and evidence-based Rehabilitation Services Department. Our compassionate team provides a wide range of inpatient and outpatient services, including acute care rehabilitation, joint replacement & spinal surgery, neurosurgery, ICU, Telemetry, step-down care, skilled nursing, as well as outpatient therapy, hand and lymphedema clinics.
GENERAL DUTIES:
The Patient Service Representative II greets patients and visitors in person or on the telephone; obtains demographic, financial and medical information for registration and identification, coordinates and assists in the completion of all activities relating to patients' finances, to facilitate the collection and distribution of information and to expedite a smooth and timely billing and collection process while adhering to department policies and procedures. Access to demographic information and limited patient health information related to job function.
The Patient Service Representative obtains, monitors and expedites the necessary authorizations and approvals for hospital outpatient services and/or elective surgeries per the designated insurance carriers.
Acts as a resource and liaison for employees within the department, as well as other inter-related hospital staff and all "guests" that need assistance or information.
DEPARTMENT SPECIFIC DUTIES:
RESPONSIBILITY
- Interviews and Registers Patients.
- Explains forms, obtains demographic and insurance information and inputs into applicable
- Patient Accounting systems. Explains hospital deposit policy and collects appropriate monies from
- patients and/or responsible parties. Promotes positive working relationships with patients, families, physicians
- and other department’s within the hospital to ensure a high level of service is provided.
- SPECIFIC DUTIES
- All patient charts are complete in a timely manner with a minimum accuracy rate of 95% on all registrations.
- Accurately enters required data in the ADT System, with emphasis on accuracy of demographic data and financial information to ensure appropriate revenue routing.
- Validates existing data related to prior registrations and updating and updates appropriately in the ADT system.
- Obtains all necessary copies of insurance cards and related documents, identifies the appropriate payor source (plan ID, financial class, etc.).
- Ensures that all pre-certifications are completed within the specified time frames as mandated by the payor’s payment authorization protocols.
- Obtains all appropriate and necessary signatures to meet regulatory requirements.
- Records comments in the ADT System to permit timely and accurate follow up.
- Accurately and timely scans all necessary/required documents into VI Web.
- Insures Trauma and Ambulance logs are maintained current to ensure proper identification of emergency room patients.
- Financially clears all ER inpatient admissions, direct inpatient admissions and/or transfers from other facilities in an
- accurate and timely manner.
- Follow-up on all accounts is accurately and appropriately documented in FUSSA notes in a manner which is clear and understandable.
- Makes assessments of Private Pay patients and/or problematic accounts and appropriately initiates referrals to Medi-Cal Eligibility Pending staff (MEP) for review of possible Medi-Cal or Charity linkage.
- Charts are audited for completeness/accuracy and all accounts are ICED within 24-hours of admission or next working day. (i.e. signatures, insurance verification, demographics).
- Requests & collects deposits, deductibles, co-pays and payment for non-covered services to reduce bad debt expense.
- Consistently meets monthly cash collection goals as outlined by Tenet Corporate Patient Financial Services/Patient Access Departments.
- Consistently process cashier receipts with a 100% accuracy rate when accepting cash payments according to established policies and procedures.
- Maintains current knowledge of financial resources in order to identify appropriate financial status for private pay.
- Patient’s (self-pay/Compact for the Uninsured, MIA, Medi-cal, Medicare only, VOC, etc.).
- Maintains current knowledge of Cerner Millennium system to ensure proper “computer down-time” registration procedures
- Maintains current knowledge of Compact for Uninsured Policy & Procedure and complies with appropriate guidelines.
- 100% of all admissions have been given a copy of the Patients’ Rights, Advanced Directive and NPP
- information and documentation is complete.
- Charts are turned in to the audit/QA area within 24 hours after discharge.
- Collect deductibles, co-payments, Compact for Uninsured Rates and establish appropriate payment
- arrangements prior to completion of treatment/discharge.
GENERAL DUTIES
- Supports and facilitates open communication with patients and families.
