Patient Access and HIM Representative
4 weeks ago
Vail Health has become the world's most advanced mountain healthcare system. Vail Health consists of an updated 520,000-square-foot, 56-bed hospital. This state-of-the-art facility provides exceptional care to all of our patients, with the most beautiful views in the area, located centrally in Vail. Learn more about Vail Health here .
About the opportunity:
This role is responsible for patient registration, admissions, and insurance related tasks. The Patient Access/HIM Representative is also responsible for the assembly, maintenance, and storage of medical records.
What you will do:
- Registers patients and performs all registration-related functions, including explaining and obtaining all necessary patient consents and authorizations in a complete and timely manner, and collecting financial paperwork (e.g., patient responsibility statement, etc.) and co-payment as required.
- Communicates effectively with patient to assist in access to care by: answering telephone and other incoming communications in a timely and customer-service oriented manner; replying to inquiries, patient needs for information, and other parties clearly and in a timely manner; and, if information is not readily available, follows up with inquiries to responsible party.
- Resolves all non-clinical questions within scope of knowledge while providing excellent customer service on the phone and/or in person.
- Performs on-going documentation audits for medical necessity, plan of care, and other related tasks or requirements by payors, including Medicare, using a variety of computer-based systems.
- If in a procedure-based department, routinely schedules appointments for all procedures educating each patient with pre-exam and if necessary, post-exam requirements within scope. Organizes, generates and distributes patient reminders, results, and recall letters.
- Manages, directs and responds to incoming office correspondence as deemed appropriate, including mail, email, faxes, and telephone calls and forward queries to the appropriate staff.
- Organizes, monitors, and orders front desk supply inventory to assure cost effective departmental spending.
- Follow the Center for Medicare & Medicare Services (CMS) requirements for checking medical necessity communicates relevant coverage/eligibility information to the patient. Identifies patients who will need Medicare Advance Beneficiary Notices (ABNs) of non-coverage and maintains accurate records of authorizations within the EMR.
- Completes Medicare Secondary Payer Questionnaire for Medicare beneficiaries in accordance with Centers for Medicare & Medicaid Services (CMS) standards.
- Accurately maintains the predetermined, organized and secured record format. Arranges the scanning of medical records and verifies completeness.
- Required to inform physicians of signed documentation delinquency according to policy and procedures.
- Communicates nursing documentation deficiencies to clinical management.
- Receives and logs requests for medical information and obtains appropriate releases before filling medical record requests.
- Assists management with month-end closing procedures. Prepares and/or reviews various month end reports.
- Assists the clinical staff with the collection and coordination of data such as blood usage, surgery complications, etc. that are included in the medical record review process.
- Receives requests for records to be reviewed by external auditors, compiles copies and/or sets up queue for these encounters to be reviewed. Validates that no restrictions apply to the encounters requested. Keeps Director informed of the status of project preparation. Mails or sends the copies in accordance with the requestor's instructions.
- Role Models the Principals of a Just Culture and Organizational Values.
- Ensures compliance with all applicable HIPAA, EMTLA and Joint commission requirements, providing required associated literature to patients.
- Performs other duties as assigned on department and organizational-level. Must be HIPAA compliant.
This description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.
What you will need:
Experience:
- Customer service and clerical experience.
- N/A
- N/A
- Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
Education:
- N/A
Benefits at Vail Health (Full and Part Time) Include:
- Competitive Wages & Family Benefits:
- Competitive wages
- Parental leave (4 weeks paid)
- Housing programs
- Childcare reimbursement
- Comprehensive Health Benefits:
- Medical
- Dental
- Vision
- Educational Programs:
- Tuition Assistance
- Existing Student Loan Repayment
- Specialty Certification Reimbursement
- Annual Supplemental Educational Funds
- Paid Time Off:
- Up to five weeks in your first year of employment and continues to grow each year.
- Retirement & Supplemental Insurance:
- 403(b) Retirement plan with immediate matching
- Life insurance
- Short and long-term disability
- Recreation Benefits, Wellness & More:
- Up to $1,000 annual wellbeing reimbursement
- Recreation discounts
- Pet insurance
Pay is based upon relevant education and experience per hour.
Hourly Pay:
$21.32 - $25.40 USD
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