Access Service Representative-Patient Placement - Centralized PAS Support - Corporate Office - Variable Shift - Per Diem

Sharp HealthCare•San Diego, CA

4d•$26 - $36

About The Position

Obtains and verifies patient demographic, visit, and financial information in a manner that facilitates departmental efficiencies, maximum financial reimbursement, and promotes premier customer service. This position will place patients via computer to assigned medical, surgical, cardiac, and critical care beds according to the Bed Protocol. Bed assignment will be communicated to the receiving and transferring floors/departments via computer system and telephone system. In an effort to provide complete customer satisfaction, this position should accurately listen and respond appropriately to requests from physicians, inter-departments, and peers. To ensure patients are assigned rooms in an expedient manner, this position will utilize all critical resources within the organization to expedite this process. This position must ensure all paperwork and computer entry is checked for accuracy and will continually enhance their knowledge regarding processes. This position should give high priority to customer service and complete customer satisfaction. This position will coordinate the successful transfer and placement of patients within the organization. This position must be able to adjust through a rapidly changing environment. This position will participate in personal and professional growth, development, and continuous improvement in all critical success factors of people, service, quality, financial, and growth. This position will be required to work weekends, and holidays.

Requirements

5 Years Hospital revenue cycle experience to include: admitting, pre billing, pre verification, or accounts receivable follow up
Medical terminology.
Insurances, billing and collections guideline/criteria.
Basic computer application experience, Centricity/ ADT,HPA, Cerner, On base, ECIN, Tele tracking, Transfer Center preferred.
Continuous use of computer, including reading and data entry, up to 90% of the shift.
Maintain an accurate typing speed of 35-40 wpm.
Organized and prioritize work activities.
Ability to communicate/discuss personal and financial matters with other healthcare workers i.e. physicians and nursing staff.
Document effectively and concisely.
Communicate effectively both verbally and in writing.
Function well in demanding/stressful environments.
Basic utilization management.

Nice To Haves

H.S. Diploma or Equivalent
Local, State, and Federal regulations governing registration/billing activities including JCAHO, Title XXII, Medicare and Medi-Cal regulations.
ICD-9, and CPT 4 coding experience
Certified Revenue Cycle Representative (CRCR) - HFMA -PREFERRED

Responsibilities

Completes all functions required to process billing of all hospital visits by producing a prompt, clean bill drop 4-7 days post patient discharge.
Completes accurate demographic data, including validation or insurance benefits for each admission.
Completes accurate visit data including updating accurate attending physician, diagnosis and patient location.
Validates accurate orders in Cerner to ensure appropriate patient type and accommodation codes are selected.
Complete and accurate insurance selection to include the competition of follow-up questions, notifications are made to payors within 24 hours.
Screens accounts and make appropriate referrals to FC or On site staff for follow up on unfunded patients.
Screens all Medicare inpatient admissions for 72-hour outpatient overlap. 72-hour outpatient overlaps are used for Medicare inpatient admits.
Complies with all rules and regulations governing Medicare and Medi-Cal billing.
Obtains all necessary attachments required for billing (i.e. hard copy authorizations, medical records. 18-1. 50-1. etc.).
Checks for Medicare eligibility, MVP or insurance website for validate insurance coverage.
Reviews and release all necessary hold bills.
Scheduled, Direct admit patients are pre-verified and pre-authorized prior to hospital admission. Urgent admissions are verified and authorized immediately or upon next business day.
Works Hold Bills at the end of reach admission process to ensure all holds are released appropriately to support the low touch billing process of the revenue system.
Receives and resolves incoming calls and instant notifications for the Centralized Patient Placement Center Department reflecting the Mission, Values and Philosophy of Sharp HealthCare.
Accurately documents the patient's visit in appropriate computer systems for all pertinent facts, information and resolutions.
Demonstrates overall system knowledge by accurate use of computer systems.
Communicates regularly to the nursing units of prospective admissions
Communicates effectively and professionally with the on-call physicians, Emergency room physicians and Case Managers when appropriate
Contributes proportionately to Department production.
Monitor all visits in TeleTracking for timely placement and accurate assignment of insurance and accommodation type.
Contact hospital departments such as Medical Records, Utilization Review, pre billing, financial counselors or external review organizations to resolve any billing or authorization delays.
Accurately follows department guidelines, policies and procedures regarding patient placement, order validation and insurance verification.
Ensures that patients move efficiently through the systems appropriately and timely collaborates with physicians, case managers and bed coordinators to ensure timely placement.
Demonstrates efficiency, organizational and multitasking skills.
Coordinates with other Patient access service departments, surgery, emergency, nursing units, ; and physicians to facilitate efficient bed placement.
Accepts instruction, coaching and counseling in a positive productive manner.
Demonstrates teamwork and cooperation through positive and supportive communication regarding Department changes, goals, policies and procedures.
Assists team members with outstanding insurance notification and verifications related to patients that are being placed or transferred.