West Tennessee Healthcare - Jackson Madison County General Hospital - Patient Access Representative I - Emergency Department

Duties

Overview

This position is responsible for completing financial clearing process within Patient Access Services 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, benefits 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. 

Responsibilities 

  • 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
  • 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
  • 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

Qualifications

Education:

  • High School Graduate, or equivalent

Experience:

  • 1-2 years health care or related experience preferred

How to Apply

Apply online at https://careers-westtennesseehealth.icims.com/jobs/42019/patient-access-representative-i/job

Hours: Full-time - Nights
date posted: 10-14-2020