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Patient Access Services Representative I
4 months ago
Kern Medical strives to recruit the highest quality candidates, resulting in a high-performance workforce that consistently delivers quality patient care.
- Extra-help employment has a limited term (up to 9 months).
- Health Benefits coverage may be offered.
Under supervision, performs patient access, registration/admitting, and financial counseling activities, which may include: patient pre-registration/registration, and admitting, patient financial counseling, researching and evaluating federal, state, and commercial insurance funding issues, and screening patients for alternative government funding.
Distinguishing Characteristics:
The Patient Access Services Representative I is the first level of the Patient Access Services Representative classification series. Incumbents have hospital/healthcare knowledge or experience, and are expected to gain specific knowledge of the importance of patient and insurance demographic information and the availability of payment options. Assignments may be made in registration/admitting, financial counseling, or related patient access areas. This classification is distinguished from Patient Access Services Representative II in that the latter performs more responsible, complex assignments. Promotion to Patient Access Services Representative II is based upon recommendation of the department head and approval of the Director of Personnel.
Essential Functions:
- Greets patients, reviews processes, and schedules appointments for exams or follow-up.
- Assembles all data and documents required for complete patient registration, including, but not limited to pre-admission, admission, pre-registration, and registration functions; completes all insurance verifications and authorizations.
- Enters all patient demographic information into STAR system; uses other department applications for eligibility and authorization.
- Assesses patient financial responsibility and collects co-pays, co-insurance, out-of-pocket, share of cost, and/or deductibles at time of admission.
- Screens admissions and informs referring physician offices, patients and their families about hospital policies and procedures regarding method of payment sources for services rendered.
- Interviews patients at the workstation and/or at the bedside to determine possible eligibility for state-funded programs.
- Obtains and documents funding information from patients and provides information on available funding resources; obtains funding for patients in the statuses of scheduling, pre-registration, registration, or post-registration as assigned.
- Uses payer resources and websites to explore and assess eligibility; initiates referrals for Medi-Cal, CMS, CCS, and KMCHP; administers KMC Financial Assistance Policy and Procedures to determine patient eligibility for discounted prices or charity care.
- Works in collaboration with all areas of the revenue cycle to identify and resolve issues and/or barriers.
- Enters a variety of fiscally related information into databases; maintains fiscal records and files.
- Submits and responds to requests for information and inquiries related to patient access processes, policies, and/or other related information; researches and resolves customer problems.
- Performs other related duties as assigned.
Employment Standards:
High School diploma or GED and six (6) months of patient access experience OR an equivalent combination of education, training, or experience sufficient to successfully perform the essential duties of the job.
Employees must maintain all health requirements designated by Kern Medical.
Candidates must provide detailed information on their equivalent combination of education and/or experience which provides the knowledge of and abilities indicated below:
Knowledge of:
State and federal government funding programs such as Medicare, Medi-Cal, CCS, TRICARE/CHAMPUS, Workers' Compensation; and commercial insurance payers; billing and reimbursement guidelines and methodologies for state and federal government and non-government payers; medical and insurance terminology; HIPAA privacy and compliance practices.
Ability to:
Communicate effectively both orally and in writing sufficient to perform the essential functions; read, understand, and apply policies and guidelines; obtain information from a variety of sources, including patients and families; use computers and various software to accomplish work; establish and maintain effective working relationships with patients, families, and other internal and external customers; use tact and empathy in working with patients and families under stressful situations; perform work effectively with frequent interruptions; perform multiple tasks in a fast paced environment; lift, carry, push or pull files; sit at work station for prolonged periods of time; and report to various departments throughout the hospital.
Supplemental:
A background check may be required for this classification.
All Kern Medical employees are designated "Disaster Service Workers". In the event of a disaster or civil disorder, all Kern Medical employees are to remain at work or to report to work in a safe and practicable manner.
Revised
February 2016
#3194
