Patient Access Services Representative II - Patient Fin. Counseling - Per Diem - Shift

Essential Functions

• Greets patients, reviews process, and schedules appointments for exam or follow-up.
• Assembles all data and documents required for complete patient registration, including, but not limited to pre-admission, admission, pre-registration, and registration functions; completes all insurance verifications and authorizations.
• Enters all patient demographic information into STAR system; uses other department applications for eligibility and authorization.
• Affirms patient financial responsibility and collects co-pay, co-insurance, out of pocket, share of costs, and/or deductibles at time of admission.
• Screens admissions and informs referring physician offices, patients and their families about hospital policies and procedures regarding method of payment source for services rendered.
• Interviews patients at the workstation and/or at the bedside to determine possible eligibility for state-funded programs.
• Obtains and documents funding information from patients and provides information on available funding resources; obtains funding for patients in the statuses of scheduling, pre-registration, registration, or post registration as assigned.
• Uses payer resources and websites to explore and assess eligibility; initiates referrals for Medi-Cal, CMS, CCS, and KMCHP; administers KMC Financial Assistance Policy and Procedures to determine patient eligibility for discounted prices or charity care.
• Calculates various pay agreements.
• Aids in training of staff members.
• Works in collaboration with all areas of the revenue cycle to identify and resolve issues and/or barriers.
• Enters a variety of fiscally related information into databases; maintains fiscal records and files.
• Responds to requests for information and inquiries related to patient access processes, policies, and/or other related information; researches and resolves customer problems.

Other Functions

• Performs other related duties as assigned.

Employment Standards: High school diploma or GED and one (1) year of patient access experience OR an equivalent combination of education, training, or experience sufficient to successfully perform the essential duties of the job. Employees must maintain all health requirements designated by Kern Medical.

Knowledge: State and federal government funding programs such as Medicare, Medi-Cal, CCS, TRICARE/CHAMPUS, Workers’ Compensation; and commercial insurance payers; billing and reimbursement guidelines and methodologies for state and federal government and non-government payers; medical and insurance terminology; HIPAA privacy and compliance practices.

Ability: Communicate effectively both orally and in writing sufficient to perform the essential functions; read, understand, and apply policies and guidelines; obtain information from a variety of sources, including patients and families; use computers and various software to accomplish work; establish and maintain effective working relationships with patients, families, and other internal and external customers; use tact and empathy in working with patients and families under stressful situations; perform work effectively with frequent interruptions; perform multiple tasks in a fast paced environment; lift, carry, push or pull files; sit at work station for prolonged periods of time; and report to various departments throughout the hospital.