Access Service Representative/Scheduler - Imaging - Spectrum Center Blvd - Day - Full Time

Sharp HealthCare•San Diego, CA

18h•Onsite

About The Position

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class.

Requirements

H.S. Diploma or Equivalent
2 Years In the medical office or business Services setting with demonstrated above-standard performance in billing, front office, scheduling, account follow-up, and at least one other area of expertise.
Medical terminology.
Insurances, billing and collections guidelines/criteria.
Local, State, and Federal regulations governing registration/billing activities including JCAHO, Title XXII, Medicare and Medi-Cal regulations.
ICD-9, RVS, and CPT 4 coding.
Basic computer functions.
Basic utilization management.
Accurately type or on-line key 35-40 wpm.
Organize and prioritize work activities.
Communicate/discuss personal and financial matters with patients and/or their representatives.
Document effectively and concisely.
Communicate effectively both verbally and in writing.
Function well in demanding/stressful environments.

Responsibilities

Obtains and processes patient demographic, visit, and financial information in a manner that facilitates maximum financial reimbursement and promotes premier customer service.
Coordinates scheduling and bed control activities that assure appropriate patient placement in hospital.
Collect and compile utilization data
Document collection efforts and results in ADT.
Follows department guidelines for self pay patients, making payment arrangements with patients prior to services rendered.
Prints and or routes schedules to appropriate departments as necessary.
Assures there are no conflicts with shared resources.
When possible, assures same doctor and same type cases follow in same room.
Assures rooms or resources are closed appropriately.
Seeks clarity before completing the scheduling function when physician orders are not clear or refers to nurse for follow up.
Asks assistance from Clinical Leads and/or Charge Nurse or their designee for extraordinary room utilization.
Informs appropriate leadership, staff, other departments and/or material management of case needs.
Patient/families are always informed of scheduling delays, including reason for delay, including reason for delay.
Offers to assist others and asks for assistance in completion of assignments, as needed.
Prioritizes effectively, keeps management informed of backlogs, and promotes a team approach in completion of job duties.
Downtime is used productively and downtime procedures are followed.
Call volume is evenly distributed amongst peers
Participates and cooperates with department quality assurance program.
Works additional/different shifts as needed
Completes all functions, at point of registration, necessary to comply with JCAHO, Title XXII, PSDA and facilitate the production of a prompt, clean bill drop 4-7 days post patient discharge.
Complete and accurate registration functions including; demographic data, visit, and insurance selection and follow up questions.
Insurance/physician notification - documented
Dissemination of admission forms - CMRI letter, ADHC, Medi-Cal questionnaire
Medical record numbers are not duplicated
Screen accounts and make appropriate Medi-Cal and CMS referrals to appropriate financial counselor or self pay rep
Complies with all rules and regulations governing Medicare and Medi-Cal billing.
Any additional functions as described in Department memos or general updates, including assisting with pre billing functions as assigned.
Obtain all necessary attachments required for billing (i.e. hard copy authorizations, medical records, 18-1, 50-1, etc.).
Assures billing compliance standards are met
Scheduled patients are pre-verified and pre-authorized prior to facility visit.
Urgent admissions are verified and authorized immediately or upon next business day
Controllable mail backs are less than 1% of total billing production
Assist with registration functions as assigned
Manages patient information per sharp healthcare confidentiality and HIPPA Policies.
If applicable, patient billing, charges are entered in a timely manner and error/discrepancies are reported and resolved timely.
Consistently follows through with all components of scheduling.
Accurately completes scheduling functions in scheduling application and or multiple applications if applicable, by filling out appropriate information (contrast, fluoroscopy, technical modifiers, pregnancy status, drug allergies, Radiologist, RN needed etc.)
Provides patient with prep procedure education and reassurance to include; what the procedure is, how long it is going to take, physician involvement, contrast administration, etc.
Retrieves diagnostic studies, lab test, films and other relevant medical history information in order to schedule patient appropriately.
Places cases in appropriate resources based on physician written order
Coordinates scheduling of tests and or re scheduling of exams; by retrieving results or physician orders to support the patient progress
Schedules stat orders within unit time standards and communicates with appropriate staff.
Verify physicians written orders and assures appropriate clinical indications of ordered exams.