HHSM - Patient Access Representative

About the role

Vail Health seeks a Patient Service Representative to join our team. Reporting to the Director of Patient Services, this position is responsible for patient registration, admissions, and associated tasks including information collection and validation, requisitioning of orders and services, and administrative functions.

Responsibilities

• 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 patients 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, following up with inquiries to responsible party.
• Solves all non-clinical questions within scope of knowledge while providing excellent customer service on the phone and/or in person.
• Performs ongoing 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.
• Establishes files, maintains information, and scans medical records in a timely and organized manner.
• 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.
• Attends and provides feedback for departmental staff meetings.
• Follows 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.
• 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.

Requirements

• Customer service and clerical experience.
• No license or certification required.
• Must have working knowledge of the English language, including reading, writing, and speaking English.

Qualifications

• No formal education required.

Skills

• Excellent communication skills.
• Ability to handle multiple tasks simultaneously.
• Knowledge of medical terminology and procedures.

Benefits

• Competitive wages and family benefits.
• Comprehensive health benefits including medical, dental, vision, and life insurance.
• Tuition assistance and educational programs.
• Paid time off and retirement plans.
• Wellness and recreation benefits.

Pay

Hourly pay range: $20.67 - $24.37 USD. Pay is based upon relevant education and experience per hour.