Patient Access Representative-ER-Full Time-8110

Safety-sensitive position. Non-exempt role reporting to the Patient Access Manager.

About the role

All KHI employees are expected to perform their tasks and duties in a manner that supports KHI’s vision to be among the kindest, highest quality health systems in the country. At the direction of management, completes the registration process for patients, including verification of benefits, discharge, collection of copays or payments, balancing of accounts, and general data entry.

Responsibilities

• Customer Service and Patient Satisfaction
  • Provides excellent customer service and contributes to overall patient satisfaction, adhering to the Behavioral Expectations Agreement.
  • Promptly fields and/or directs incoming calls; responds to patient and/or staff inquiries.
  • Refers patient accounts to financial counselors when further explanation/education is needed (e.g., denied authorizations, out-of-pocket liabilities, coverage options, payment plans).
  • Demonstrates willingness to assist co-workers to support department efficiency and positive customer feedback goals.
  • Participates in ongoing process improvement activities for the team.
  • Floats to other work areas as requested and regularly works nights, weekends, holidays, and extended hours when needed.
• Registration/Admitting/Discharge of Patients
  • Demonstrates ability to preregister, register, schedule, reschedule, and discharge patients according to defined guidelines.
  • Enters new patient data and/or verifies patient records are up to date; confirms completeness of the electronic health record (EHR) and makes changes as necessary.
  • Verifies insurance eligibility and benefits within a timeframe determined by KHI.
  • Obtains pre-authorizations from third-party payers in accordance with payer requirements, when needed.
  • Ensures identified information is complete and scanned into patients’ EHR (insurance cards, photo IDs, physician orders, and other admission documents).
  • Obtains signatures on all required forms.
  • Manages co-payments, deductibles, and allowances as instructed.
• Patient Processing
  • Accurately balances daily cash, including completion of daily cash log, bank deposit slip, and daily reports to Patient Financial Services.
  • Accurately utilizes insurance eligibility/audit tools and reports/corrects variances within the EMR.
  • Quality performance scores must meet defined goals.
  • Verifies insurance eligibility and benefits within a timeframe determined by KHI and obtains pre-authorizations from third-party payers in accordance with payer requirements.
  • Collects upfront co-pays, deductibles, and coinsurance; secures deposits on self-pay and high accounts.
  • Regularly works nights, weekends, holidays, and extended hours when needed.
• Lead PAR Responsibilities (if applicable)
  • Meets all PAR requirements.
  • Provides day-to-day leadership and supervision of PAR team members, trains and orients new hire PARs, and works with supervisors to provide continuous training of existing staff.
  • Performs QA audits of registrations, works account checks, and responds to account denials.
  • Assists with staff scheduling to ensure appropriate coverage.
  • Participates in interviews for hiring new staff and provides feedback to PAR supervisors for performance evaluations.
  • Identifies, supports, and manages process improvement initiatives for the team.
  • Collaborates with management to assist in the day-to-day operations of the team.

Requirements

• Demonstrates ability to multitask, prioritize appropriately, and manage time efficiently.
• Effective oral and interpersonal communication skills.
• Demonstrates ability to utilize a variety of technological resources (phone, computer hardware, various software programs, fax, scanner).
• High School Diploma or equivalent.
• Experience:
  • PAR: Minimum of 1 year of experience working in a customer service position and/or office setting.
  • Lead PAR: Minimum of 1 year of registration or billing experience in a healthcare setting.
• American Heart Association BLS certification.
• DPS Level 1 Fingerprint Clearance Card required for the following departments/clinics:
  • Resident Clinic
  • Joshua Tree Pediatrics
  • Urgent Care
  • Mountain Shadow Primary Care
  • Golden Valley Medical Center
  • Patient Access
  • Physician Services Float Pool

Work Requirements

• Able to reach above and below shoulder level, lift, bend, kneel, squat, stand, walk, and sit for the full scheduled shift.
• Able to use telephone and computer software and hardware for most of the shift (90% of the day).

Preferences

• Previous experience in healthcare registration, scheduling, and/or authorizations.
• Multi-lingual skills.

Special Position Requirements

Exposure Category II: Expected duties have possible, but not routine, potential for exposure to blood, body fluids, or tissues.