Coordination Center Patient Access Associate 2

The Patient Access Associate 2 must be competent in the following: registering, scheduling, insurance/Medicare/Medicaid compliance and strong customer service skills. The Patient Access Associate 2 must have the ability to work independently in a fast-paced environment. The Patient Access Associate 2 will accurately collect, analyze and record demographic, insurance/financial and clinical data from multiple sources, and obtain other information and signatures necessary for registration and billing. Effectively screen for compliance with payer requirements for medical necessity and precertification and complete third-party eligibility and benefit verification to ensure accurate payment is secured.
PART III: POSITION RESPONSIBILITIES (ESSENTIAL FUNCTIONS)Accurately collects and analyzes all required demographic, insurance/financial, and clinical data necessary to schedule, pre-register, and register patients from all payer classes. Interacts with patients, their representatives, physicians, physician office staff, employers, and others. Reviews new and previously recorded information. Electronically records information on a timely basis. Follows EMTALA, HIPAA, payer and other applicable regulations and standards for registration. Accurately prepares required forms, documents and reports, including labels, ID bands, and all other necessary documentation. Produces and distributes these on a timely basis to both internal and external parties. Appropriately explains, secures, and witnesses all signatures required to provide medical treatment, assignment of benefits, release of information, establish financial responsibility and to assist in meeting other internal, regulatory and payer requirements. Completes consent with OON Insurance when applicable.Completes the MSP questionnaire when applicable. Reviews physician orders and other documentation against payer coverage and medical necessity criteria, uses screening software to determine whether services being provided meet third-party requirements for payment, contacts physicians as necessary for additional clinical information, informs physicians about payer requirements, initiates Medicare ABN process as appropriate and explains payer policies to patients. Documents in notes all financial expectations of payer or patient and medical necessity verification. Gives business card for every registration. Uses scripting and AIDET for patient satisfaction and registration process.Acts as a team member assisting with finding or providing coverage for call-offs to ensure appropriate coverage. Documents call offs in log. Follows policy and procedure Coordination Center for vacation, call offs, and coverage procedures.Assists with transportation of patients within the hospital, and in securing transportation of patients to and from the hospital. Ensures the highest level of customer satisfaction is provided by self and department. Keeps patient and family members informed of process and any delays.Attends all mandatory department meetings, advanced registration classes and OLIE courses.Coordinates inpatient bed placement with clinical or other staff, properly reports admissions and all pertinent information to all necessary departments in a timely and accurate manner. Enters admission information in a timely and accurate basis. Interprets physician orders for service, uses appropriate accommodate and service codes to ensure revenue is properly recorded and bills produce accurately.Explains hospital credit and collection policies and payment options to the patient or responsible party, and negotiates acceptable resolution of expected self-pay balance. Refers self-pays to financial counselor or cashier. Use PPE when applicable to determine amount due. Consistently uses collection at time of service scripting.Handles all codes per policy and procedure to ensure timely response. Uses codespear accurately and timely.Operates switchboard and handles incoming calls in a compassionate customer focused manner. Identifies self to all internal and external customers during direct communication with external customers to determine the appropriate location and process that needs to occur. Consistently uses scripting 'Thank you for calling Riverside, this is xxxxx, how may I help you?'Picks up, sorts, and distributes mail and faxes daily. Assist in the distribution and replacement of pagers. Updates switchboard reference materials as needed. Takes initiative to report repairs to appropriate areas or vendors.Updates Intellisource and RQI accurately and timely. Reviews 271 responses and updates insurance information as applicable.
Experience/Education Requirements:
High School Diploma or equivalent required
Computer literacy
Medical Terminology preferred
Office or other clerical experience preferred
Ability to read and write in English. Verbal skills required to interact on the telephone or in person in a courteous and respectful manner
Ability to do general arithmetic
Prior Admitting and Switchboard experience preferred
Prior knowledge of payer regulatory compliance and HIPAA Privacy and Security requirements
Detail oriented, committed to accuracy, and ability to problem solve
Prior customer service experience preferred
Must be able to type 35 WPM with spelling accuracy of 85% License or Certification Requirements:

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