Patient Access and HIM Representative

4 weeks ago

Dillon, Colorado, United States Vail Health Full time
About the Role

Vail Health is seeking a highly skilled and detail-oriented individual to join our team as a Patient Access and HIM Representative. This role is responsible for ensuring seamless patient registration, admissions, and insurance-related tasks. The successful candidate will also be responsible for maintaining accurate and organized medical records.

Key Responsibilities
  • Registers patients and performs all registration-related functions, including explaining and obtaining necessary patient consents and authorizations.
  • Communicates effectively with patients to assist in access to care, answering phone calls and responding to inquiries in a timely and customer-service oriented manner.
  • Resolves non-clinical questions within scope of knowledge while providing excellent customer service.
  • Performs ongoing documentation audits for medical necessity, plan of care, and other related tasks or requirements by payors.
  • Manages, directs, and responds to incoming office correspondence, including mail, email, faxes, and telephone calls.
  • Organizes, monitors, and orders front desk supply inventory to ensure cost-effective departmental spending.
  • Follows CMS requirements for checking medical necessity and communicates relevant coverage/eligibility information to patients.
  • 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 CMS standards.
  • Accurately maintains predetermined, organized, and secured record format, arranging the scanning of medical records and verifying 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, preparing and/or reviewing various month-end reports.
  • Assists 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, keeping Director informed of the status of project preparation.
  • Mails or sends 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.
Requirements
  • Customer service and clerical experience.
  • Must possess, or be able to obtain within 90 days, the computer skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
  • Must have working knowledge of the English language, including reading, writing, and speaking English.
Benefits

Vail Health offers a comprehensive benefits package, including competitive wages, family benefits, comprehensive health benefits, educational programs, paid time off, retirement and supplemental insurance, and recreation benefits, wellness, and more.

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