Access Service Representative - Admitting/ED - Coronado Hospital - Evenings and Nights - Part Time (0.5)

About the role

This position is covered by a Collective Bargaining Agreement (CBA) with SEIU-UHW. As part of the terms of employment, employees in this role are required to join the union within 31 days of hire and remain a member (e.g. dues paying, fee paying, religious exception contributor) for the duration of the collective bargaining agreement.

Responsibilities

• Collections
• Follow department guidelines for providing patient with estimate letter.
• Request payment of co-pay, deductible, estimated out of pocket or good-faith deposit in a manner specified in department and hospital policies. If patient unable to pay requested amount, negotiate some portion.
• Receive and process funds, print and file receipt, and update Centricity visit comments. Secure all funds and receipts in accordance with department standard.
• Completes insurance verification and evaluation
• Insurance/Plan Selection:
• After medical screening (ER settings), obtain health benefit coverage including possible accident related coverage. Input all insurance coverage information into Centricity Insurance Verification (IF).
• Use Coordination of Benefits (COB) standards to prioritize billing order of insurance plans.
• Medicare patients - Medicare Secondary Payer (MSP) questionnaire is completed.
• Validate insurance eligibility electronically (e.g. MPV, Experian) when applicable. Validate health benefit coverage including possible accident related coverage.
• Validate and identify the Primary Medical Group on Health Maintenance Organizations (HMO) patients. Notify the clinical staff, including physician, on patients that are out-of-network.
• Follow process to estimate patient out of pocket based upon department guidelines and collect patient financial responsibility.
• Communicate to patient and leadership when unusually high out of pocket, unusually limited coverage, and/or if insurance is out of network (OON) following the guidelines established for the facility.
• Unfunded:
• Initiate interview on unfunded/underfunded patients. Input financial screening results into Pointcare fields as appropriate and provide patient with potential coverage options. Complete the process by recording the outcome through X8 function.
• Complete HPE (Hospital Presumptive Eligibility) process when appropriate.
• Document in Centricity visit comments if patient declined or completed financial screening.
• Complete self-pay process (aka toolkit) to discuss the Sharp out of pocket expectation.
• Customer service
• Use AIDET, key words at key times, On-Stage Behavior and support 5-star results on patient satisfaction.
• Communicates effectively both orally and in writing sufficient to perform the essential job functions. Use tact and empathy in working with customers under stressful situations and with frequent interruptions.
• Avoid abbreviations when communicating to patient.
• Adapt and protect patient privacy as needed (i.e. lowering voice, using face sheets vs. verbal interviews).
• Practice good interpersonal and communication skills and ability to work well with others contributing to a team environment.
• Practice a positive and constructive attitude at all times.
• Negotiates with others, handles minor complaints by settling disputes, grievances, and conflicts.
• Perform service recovery when The Sharp Experience does not go right in accordance to the department standards and Sharp's Behavior Standard Service Recovery.
• Identify solutions to issues not covered by verbal or written instructions.
• Demonstrates initiative and teamwork
• Prioritize job responsibilities effectively. Keep management informed of backlogs or slow volume. Round on patients when volumes are low as identified by your department.
• Patients are processed timely based upon depart standards such as quality audits, time, and production measurements.
• Offer to assist others and asks for assistance in completing of assignments, as needed.
• Inform patient/families of admission delays and cause if known or allowed.
• Promotes a team approach in completion of department duties.
• Contributes to department production by maintaining expected level of productivity designated by the department.
• Other duties
• As directed by Leadership, provide ongoing support of department and hospital needs as assigned.
• When applicable, collect patient valuables according to policy and secure them by entering into log and dropping into department safe. Follow hospital policy to release valuables.
• When applicable, update Patient Type, Bed Placement, Accommodation Code, Attending Physician.

Qualifications

• 2 Years experience in a business service setting.
• Must have experience communicating effectively both verbally and in writing professionally.
• H.S. Diploma or Equivalent
• Experience communicating and discussing personal and financial matters with patients and/or their representatives is preferred.
• HFMA certifications preferred.

Skills

• Knowledge of Medical Terminology.
• Knowledge of insurances, billing and collections guidelines/criteria.
• Knowledge of Local, State, and Federal regulations governing registration/billing activities including Joint Commission, Title XXII, Medicare and Medi-Cal regulations.
• Knowledge of ICD-10, CPT, and/or RVS coding.
• Knowledge of Medicare Important Message, Medicare Secondary Payor, Tricare Third Party Liability; Auto Accident and Work Comp, Medicare/Outpatient Observation Notice.

Benefits

Not specified

Pay

$25.300 - $34.000

Schedule

Variable