Access Service Representative - Admitting/ED - Coronado Hospital - Variable Shift - Full Time

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.

About the Role

Performs out-patient registration process for ancillary areas and promotes premier customer service. The Patient Access Services (PAS) department coordinates all phases of the revenue cycle from pre-registration up to and including departures, referrals, and denial management. This role performs pre-registration/registration functions prior to or at the time of the visit date to initiate a medical record and bill, obtain demographic, visit, and financial information.

Responsibilities

• Perform pre-registration/registration functions to obtain demographic, visit, and financial information.
• Confirm insurance benefits with online verification systems or telephone inquiries.
• Generate, complete, and distribute all applicable PAS ancillary forms for each visit.
• Secure appropriate information for referrals and authorizations required from insurances.
• Coordinate the ancillary area to promote patient safety, handle incoming ancillary department phone calls, and monitor the ancillary waiting area.
• Cash collection:
  • Notify scheduled patients with any self-pay liability at least 1 day prior to procedure.
  • Negotiate payment if patient is unable to pay the requested amount.
  • Request payment of co-pay, deductible, or coinsurance portion due prior to the service.
  • Receive funds, issue receipts, and update Centricity visit comments to ensure proper crediting and auditing of receipts.
  • Provide adequate security for all funds and receipts at all times.
  • Prepare, verify, and reconcile ancillary deposits according to department and hospital standards.
  • Competently use the self-pay price quote system.
• Insurance verification and authorizations:
  • Review all scheduled patient accounts to ensure pre-verification prior to the procedure.
  • Use Centricity Business Visit Manager to review all pre-scheduled radiology procedures and complete the Visit Manager checklist.
  • Review insurance coverage information in Centricity Business and use standard Coordination of Benefits standards to prioritize billing order.
  • Verify insurance eligibility and benefits in MPV.
  • Ensure all required hard copy authorizations are scanned in.
  • Identify co-pay amount and other patient liabilities including coinsurance and deductible amounts.
  • Update Centricity visit comments with expected patient out-of-pocket costs.
  • Comply with all rules and regulations governing Medicare and Medi-Cal billing, ensuring all billing compliance standards are met.
  • Review all hold bills and work as appropriate.
• Department operations:
  • Answer incoming ancillary phone lines respectfully and handle call volume efficiently.
  • Review ancillary computer systems to assist with monitoring patient flow and wait times.
  • Inform patients and families of delays, including reasons for delay.
  • Monitor ancillary waiting area and provide updates to patients as needed.
  • Demonstrate teamwork and cooperation with the ancillary area through positive communication.
  • Use downtime productively and prioritize effectively, keeping management informed of backlogs.
• Patient data management:
  • Populate all demographic screens for new and established patients to comply with Sharp Registration Standards.
  • Secure patient signature on address attestation.
  • Deliver the Notice of Privacy Practices (NPP) and Patient Rights to patients new to Sharp Healthcare.
  • Update the registration field related to NPP.
  • Obtain accident-related information and update appropriate visit fields.
  • Enter appropriate diagnosis with no abbreviations.
  • Secure Primary Care Provider information.
• Patient safety:
  • Coordinate check-in of all scheduled and non-scheduled patients to ensure patient safety.
  • Authenticate and/or enroll patients in Patient Secure palm scanning, following established guidelines such as scripting and picture identification.
  • In the absence of Patient Secure, use at least two patient identifiers to confirm patient identity.
  • Review physician orders to facilitate check-in and prioritize scheduled patients appropriately.
  • Notify DUPREG when potential duplicate registrations are identified.
• Regulatory:
  • Review Conditions of Admission (COA) with patients using scripting, secure signature, and update the COA field.
  • Complete Medicare Secondary Payer (MSP) questionnaire for Medicare patients.
• OnBase:
  • Use OnBase to review physician orders.
  • Obtain and scan all necessary access service-related documents (e.g., physician orders, hard copy authorizations, ID cards, and insurance cards).
  • Ensure all scans are clear, associated with the correct identifier, and located on the appropriate account.

Requirements

• High School Diploma or equivalent.
• HFMA Certification preferred.

Skills

• Ability to communicate and discuss personal and financial matters with patients and/or their representatives.
• Effective and concise documentation skills.
• Strong verbal and written communication skills.
• Ability to function well in demanding and stressful environments.

Pay

Hourly pay range: $25.300 - $30.360 - $34.000

Schedule

• 8-hour shifts (8/40 schedule).
• Shift start and end times are variable.
• Weekend requirements: every other weekend.
• On-call: Not required.