West Tennessee Healthcare - Patient Access Representative I - UT Family Medicine

Duties

Job Summary/Scope of Responsibility

This position is responsible for completing financial clearing process within Patient Access Services (PAS) and creating the first impression of services to patients and families of all external customers. The PAS Representative must be able to articulate information in a manner that patients, guarantors, and family members understand so they know what to expect and have an understanding of their financial responsibilities. This position assumes responsibility for collecting and documenting information on behalf of the patient.

The PAS Representative may be responsible for completing the pre-registration, registration, insurance verification, certification, referral management, patient liability collections, and medical necessity check - as well as interviewing patients and guarantors to obtain information to screen for financial counseling, verifying eligibility and corresponding benefit levels, coordinating referrals, and obtaining treatment authorizations.

The PAS Representative will also work with medical staff, nursing, ancillary departments, insurance payers, and other external sources to assist families in obtaining healthcare and financial services. Employee is subject to call back and overtime as required by the hospital.

Essential Job Functions: 

  • Process - Maintains the best practice routine per departmental guidelines. Daily work queues are maintained at acceptable levels according to departmental polices. Correspondence worked daily to current.
  • Registration - Performs financial clearance process by interviewing patients and collecting and recording all necessary information for pre-registration of patients. Ensures that proper insurance payer plan choice and billing address are assigned in the automated patient accounting system. Verifies relevant group/ID numbers
  • Completes the registration process according to established policies and procedures
  • Ensures patient receives necessary disclosures, privacy information, and signs the relevant documentation
  • Financial Clearance - Contacts payers to verify insurance eligibility. Completes automated insurance eligibility verification, when applicable, and appropriately documents information in patient accounting system. Determines the patient's insurance type and educates patient's insurance types and educates patients regarding coverage and/or coverage issues.
  • Informs families with inadequate insurance coverage regarding financial assistance through government and financial assistance programs. Performs initial financial screening and refers accounts for financial counseling and/or appropriate eligibility assessments.
  • Ensures all referrals and treatment authorizations for all patient types have been obtained according to the outlined requirements. If not obtained, contact payers for approvals.
  • Completes initial medical necessity checks. Refers to designated area if medical necessity fails or if referrals / authorizations are denied
  • Pre-Service / Point of Service Collection - Interprets third party payer policies to establish patient financial liabilities and work with patients so they understand their patient financial responsibilities.
  • Collect co-payments, co-insurance, and deductibles according to pre-service / point of service collections policies and procedures.
  • Communication and Miscellaneous - Advises next level leader of possible postponement or deferrals of any elective / non-emergent admission which has not been approved prior to service date. Maintains accurate files for pre-processing information as required.
  • Investigates, resolves, and documents patient problems in a timely and efficient manner
  • Maintains accurate files for pre-processing information as required
  • Investigates, resolves, and documents patient problems and contact medical staff, nursing staff, ancillary departments, and administration as necessary
  • Assists with cross training function in areas within Patient Access Services
  • Performs related responsibilities as required or directed 

Qualifications

Job Specifications

Education:

  • High School Graduate, or equivalent

Experience:

  • 1-2 years health care or related experience preferred

Knowledge, Skills and Abilities:

  • Ability to type 35 words per minute with accuracy
  • Demonstrated knowledge of healthcare management, registration, billing, collection processes for government, grant, and non-government funding sources
  • Demonstrated strong attention to detail and ability to obtain and record information accurately in the patient accounting system
  • Requires the ability to lean and apply various rules, regulations, policies and procedures, criteria and eligibility thresholds set forth by hospital's external government/regulatory agencies, and payer contracts
  • Comfort with data entry with Revenue Cycle software, patient management systems, and Windows based applications preferred
  • Knowledge of word processing and spreadsheet applications
  • Strong interpersonal skills and ability work through a variety of issues in a diplomatic fashion required

Interpersonal Requirements:

  • Ability to contribute to a positive work environment and the overall team effort on the department

Physical Demands:

  • Lift 0-50 lbs.
  • Carry 0-50 lbs.
  • Push 0-50 lbs.
  • Pull 0-50 lbs.
  • Stoop, Kneel
  • Crawl
  • Climb
  • Balance
  • Work Position
  • Sitting
  • Walking
  • Standing

Environmental Conditions:

  • Works in normal office environment where there are few physical discomforts due to temperature, noise, dust, and the like
  • Equipment used, but not limited to: computer, printer, copier, fax machine, scanner, telephone, headsets, calculator, etc. 

Other Job Requirements:

  • Responsible for other duties as assigned
  • Understands and adheres to West Tennessee Healthcare's compliance standards as they appear in the Compliance Policy, Code of Conduct, and Conflict of Interest Policy
  • Assumes responsibility for insuring continued professional growth

How to Apply: 

  1. Go to https://applicants.wth.org/careers/. Click on the "Log-In/Register" tab on the upper right hand corner.
  2. Create an account by clicking on the "Unregistered External User?" link located in the lower left hand side of the login box and fill out the necessary information.
  3. Click on the "Resume" tab located at the top of the page.
  4. Begin the application process. Make sure you click "Save" after each tab. Please note that you may be asked to upload your resume and a cover letter for the job that you are apply for.
  5. Once  completed, click "Save"
  6. Apply for jobs by clicking on the "Search" tab at the top of the page.
  7. At the top of the search page type in the title of the position that you are applying for in the "Job Title/Job Description" box. The job will be listed if the position is still available.
  8. Click on the Job Title and obtain any information needed to complete the application process.

Hours: Full-time
date posted: 11-28-2018