Patient Access Representative III - 140520

About the role

Under the general guidance of the Access Manager, Patient Access Rep/HAIII; pre-registers, pre-admits, and admits patients by telephone and/or in person. Major duties include: efficiently collect accurate demographic information, review and interpret complex insurance benefits, obtain prior authorizations, patient estimates, cash collections, interaction with public assistance programs (i.e., Medi-Cal, CCS), implementation of Medicare requirements, interaction with physicians/office personnel as well as other hospital personnel, units and departments, and referral of appropriate cases to other internal and external sources to assist patients with discharge/post-hospital care. Interact with hospital departments such as Utilization Review and Patient Business Services to ensure correct and timely reimbursement.

Responsibilities

• Efficiently collect accurate demographic information
• Review and interpret complex insurance benefits
• Obtain prior authorizations, patient estimates, cash collections
• Interaction with public assistance programs (i.e., Medi-Cal, CCS)
• Implementation of Medicare requirements
• Interaction with physicians/office personnel as well as other hospital personnel, units and departments
• Referral of appropriate cases to other internal and external sources
• Interact with hospital departments such as Utilization Review and Patient Business Services
• Ensure correct and timely reimbursement

Requirements

• A minimum of three (3) years of registration or medical front office experience or equivalent combination of education and experience
• Thorough Knowledge of third-party payers
• Demonstrated knowledge of medical terminology
• Excellent customer service skills
• Highly proficient with MS Office applications (Excel, Word)
• Possess strong communication skills, with the ability to convey complex ideas clearly both verbally and in writing to audiences at all levels
• Possess the personal characteristics of professionalism, credibility, commitment to high quality standards, innovation, and accountability
• Ability to interact effectively with the public, including patients, visitors, clinical and support staff

Qualifications

• Patient Access experience in a hospital setting
• UC San Diego - Extended Studies Intensive Revenue Cycle Course Certificate
• Experience with insurance and authorization verification
• Strong knowledge of third party payors including federal, state, and private health plans
• Bilingual English/Spanish
• Knowledge of medical terminology
• Knowledge and articulation of hospital patient forms, as required by JACAHO/GAD, etc.
• Prior cash handling experience
• Experience completing Birth certificates

Skills

• Excellent customer service skills
• Highly proficient with MS Office applications (Excel, Word)
• Strong communication skills, with the ability to convey complex ideas clearly both verbally and in writing to audiences at all levels
• Personal characteristics of professionalism, credibility, commitment to high quality standards, innovation, and accountability
• Ability to interact effectively with the public, including patients, visitors, clinical and support staff

Benefits

Not specified

Pay

Annual Full Pay Range: $57,399 - $71,347 (will be prorated if the appointment percentage is less than 100%)

Hiring Pay Scale: $27.49 - $34.17 / Hour

Schedule

Days, Variable, Variable

Application

To apply, please visit Apply Now.