Responsible for the resolution of funding issues for insured or underinsured hospital patients; assisting with the timely screening and processing of potential recipients of financial assistance programs in order to minimize non-resourced accounts and for the provision of routine patient access activity for ancillary, diagnostic, surgical and emergency services as assigned to facilitate efficient operations, expeditious reimbursement and optimal customer satisfaction and employee satisfaction
The following describes the basic position duties that an employee MUST be able to perform for this role. This information is intended to be descriptive of the key responsibilities of the position. The list of essential functions below DOES NOT identify all duties performed by any single person in the position.
Is skilled in a range of processes, procedures and systems to carry out assigned tasks or has developed deep skills in a single area
Understands the roles of all immediate team members and has a good understanding of how own team integrates with others
Regularly provides guidance and support to more junior team members on challenging problems; helps them balance their workload and apply their skills
Provides solutions to problems in situations that are atypical or occur infrequently based on practice and existing precedents
Impacts the quality, timeliness and effectiveness of the team
Uses discretion to modify work practices and processes (but not policies or procedures) to achieve results or improve efficiency
Clearly and accurately conveys complex information
JOB SPECIFIC RESPONSIBILITIES: PLEASE LIST BY ORDER OF IMPORTANCE
Performs routine financial counseling activity including screening for government programs and financial assistance, payment arrangements, processing point of service payments, obtaining signatures for required paperwork, document imaging and following documentation standards to facilitate efficient patient access according to assigned protocol
Performs routine patient access transactions including coverage eligibility, insurance verification, discount eligibility, patient portion calculation and authorization requirement activity utilizing available systems and resources according to assigned protocol
Resolves routine to complex patient issues and assist with questions on insurance coverage, discount eligibility, treatment costs and reimbursement
Demonstrates the components of the Children's Health System Vision, Mission and The Children's Way Values
Demonstrates compliance with performance standards, guidelines, regulations and policies and procedures and third party contracts
Provides significant input for and participates in team-oriented process improvement initiatives for the department and organization
Follows all safety rules while on the job, reports accidents promptly and corrects minor safety hazards
Performs other duties as assigned
Workers, Patient Access Representatives, Language Access Services Representatives
Two - three years of customer service experience with two years of healthcare experience including Patient Access operations activities Required
Knowledge of general procedures and guidelines used by health insurance companies, government agencies, employer benefit departments and internal departments as they relate to registration Required
Excellent mathematical skills, computer skills, Microsoft applications and word processing programs skills and minimum of 40 words per minute Required
Ability to develop and maintain productive working relationships to fully integrate within a team Required
Proficient in English, written and verbal, communication skills Required
High school diploma or equivalent Required
Two-year Associate's degree or equivalent experience Required
Specific Knowledge, Skills and Abilities:
Maintain effectiveness when experiencing major changes in work responsibilities or environment; adjust effectively to work within new work structures, processes, requirements, or cultures.
Use appropriate interpersonal styles to establish effective relationships with customers and internal partners; interact with others in a way that promotes openness and trust and gives them confidence in one's intentions.
Ensure that the customer perspective is a driving force behind business decisions and activities; craft and implement service practices that meet customers' and own organization's needs.
Develop and use collaborative relationships to facilitate the accomplishment of work goals.
Identify and understand issues, problems, and opportunities; compare data from different sources to draw conclusions; use effective approaches for choosing a course of action or developing appropriate solutions; take action that is consistent with available facts, constraints, and probable consequences.
Take prompt action to accomplish objectives; take action to achieve goals beyond what is required; be proactive.
Deal effectively with others in an antagonistic situation; use appropriate interpersonal styles and methods to reduce tension or conflict between two or more people.
Effectively manage one's time and resources to ensure that work is completed efficiently.
Accomplish tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time.
Set high standards of performance for self and others; assume responsibility and accountability for successfully completing assignments or tasks; self impose standards of excellence rather than having standards imposed.
Assimilate and apply new job-related information in a timely manner.
Clearly convey information and ideas through a variety of media to individuals or groups in a manner that engages the audience and helps them understand and retain the message.
LICENSES and CERTIFICATIONS:
National Association of Healthcare Access Management CHAA Certification Preferred
Healthcare Financial Management Association CRCR Certification Preferred
Light - Exerting up to 20 lbs. occasionally, 10 lbs. frequently, or negligible amounts constantly and may require walking or standing to a significant degree.