Duties may vary based on assigned department but this position performs the following tasks: schedules and/or pre-registers patient visits or admissions with accurate patient demographic and financial information while providing timely and courteous customer service, ensures maximum reimbursement on all services with timely and accurate verification of coverage, completion of all third party payer requirements (referrals and authorizations), requesting and processing upfront payments, making appropriate referrals to financial counseling, and assisting guarantors with questions related to billing, assists families with questions on the complexities of the healthcare reimbursement process, answer phone calls and greets visitors, patients and families, provide directions and answer questions, provide training and guidance to Patient Access Representatives and assistance with non-routine or complex tasks.
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.
Has established skills to perform a range of day-to-day activities
Understands how own duties relate to others in the team and has an awareness of how the team integrates with others
Manages own workload by applying an understanding of team priorities; may provide assistance to less experienced colleagues
Recognizes and solves typical problems that can occur in own work area without supervisory approval; evaluates and selects solutions from established options
Impacts own team through the quality of the service or information provided; Follows standardized procedures and practices and receives regular but moderate supervision and guidance
Uses foundational communication skills to exchange straightforward information
JOB SPECIFIC RESPONSIBILITIES:
Verify third party coverage for all visits to ensure all services are reimbursed (through real time eligibility in EPIC, using the internet or by phone to the payer). Understands the complexities of and complete all third party payment requirements by obtaining timely referrals and accurate authorizations within the required timelines. Request payments at the point of service when appropriate. Process credit cards and reconcile monies received. Make appropriate referrals to financial counseling for uninsured and underinsured patients. Assist guarantors with questions related to the complexities of the healthcare reimbursement process.
Schedule clinic visits utilizing the template format designed for each service area. Register or pre-register patient visits in clinics, the emergency room, ancillary services, day surgery or admission with accurate patient demographic and financial information. Complete all legal requirements related to registration, including the completion of consent forms, HIPAA Privacy Rules, Patient Rights and Responsibilities, etc. Check in and check out patients. Enter charges and diagnostic codes.
Provide leadership and direction to Patient Access Representatives. Provide training on an as needed basis - be a systems "super user". Assist with non-routine or more complex tasks or questions.
Answer phone calls within four rings, obtain appropriate information, route calls as needed, research issues. Ensures clinical information coincides with orders and scheduled appointments. Ensure a smooth workflow within the department.
Perform other duties and responsibilities as assigned.
Minimum 6 months - 1 year of related experience required.
Customer service experience, preferably in healthcare or a service industry required.
Demonstrated successful experience (minimum of 6 months) as a Patient Access Representatives required.
High school diploma or equivalent required.
Two-year Associate's degree or equivalent experience preferred.
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.
very highly regarded in the community. I had no idea how many lives Children’s Health had helped until I started wearing my scrubs with our logo on them. I am always getting stopped with compliments about our care.
Speech Language Pathologist