Access Service Representative - Emergency - Memorial Hospital - Night - Per Diem

Sharp HealthCare•San Diego, CA

1d•Onsite

About The Position

Coordinates emergency department registration functions to support clean claims, maximize financial reimbursement, and provide premier customer service. The role collects and processes patient demographic, visit, and financial information; uses Patient Secure to identify the correct medical record; conducts face-to-face interviews with patients or designated representatives; delivers regulatory documents; and secures patient financial responsibility while following EMTALA requirements. The representative verifies insurance coverage, selects and prioritizes plans, estimates patient out-of-pocket costs, collects payments, and assists patients who are uninsured or underinsured with financial screening and potential coverage options. The role also performs customer-service and service-recovery activities, protects patient privacy, supports department productivity and teamwork, and completes registration documentation and document imaging. Additional duties may include patient valuables, bed-placement and admission data, and, where applicable, Emergency Department unit clerk or Customer Information Center tasks.

Requirements

At least 2 years of experience in a business service setting.
Ability to communicate effectively and professionally both verbally and in writing.
Knowledge of medical terminology.
Knowledge of insurance, billing, and collections guidelines or criteria.
Knowledge of local, state, and federal regulations governing registration and billing activities, including Joint Commission, Title XXII, Medicare, and Medi-Cal regulations.
Knowledge of ICD-10, CPT, and/or RVS coding.
Knowledge of Medicare Important Message, Medicare Secondary Payer, Tricare Third Party Liability, auto accident and workers' compensation processes, and Medicare/Outpatient Observation notices.

Nice To Haves

High school diploma or equivalent.
Experience communicating and discussing personal and financial matters with patients and/or their representatives.
HFMA certifications.

Responsibilities

Coordinate patient registration functions and collect accurate demographic, visit, and financial information to support clean claims and reimbursement.
Authenticate or enroll patients using Patient Secure when available; otherwise confirm identity using at least two identifiers, and report potential duplicate registrations.
Collect and update patient demographic and regulatory information, obtain required signatures, and document accident-related, trauma, Doe, or homeless-patient details according to established processes.
Verify insurance eligibility and coverage, enter insurance information, apply Coordination of Benefits standards, complete Medicare Secondary Payer questionnaires when applicable, and identify primary medical groups for HMO patients.
Notify clinical staff about out-of-network patients and communicate unusually high out-of-pocket costs, limited coverage, or out-of-network status to patients and leadership as directed.
Estimate patient financial responsibility, request and process payments or deposits, negotiate partial payment when necessary, issue receipts, update visit comments, and secure funds according to policy.
Interview uninsured or underinsured patients, enter financial screening results, provide potential coverage options, complete Hospital Presumptive Eligibility when appropriate, and document outcomes.
Follow EMTALA requirements by delaying financial discussions until after medical screening in emergency settings; review and deliver applicable admission, privacy, Medicare, Tricare, and observation notices and document outcomes.
Request primary care provider information and initiate Health Information Exchange processes as appropriate; address outstanding regulatory alerts according to department workflow.
Secure and scan Access Service documents to the correct form or identifier.
Use AIDET and other department service standards, communicate tactfully and empathetically, protect patient privacy, handle minor complaints, and perform service recovery when needed.
Prioritize work, keep management informed of backlogs or slow volume, process patients timely, maintain expected productivity, assist coworkers, and contribute to a team environment.
Inform patients or families of admission delays when appropriate and perform other duties assigned to support department and hospital needs.
When applicable, collect, log, secure, and release patient valuables according to policy; update patient type, bed placement, accommodation code, or attending physician information.
Where assigned to ED Unit Clerk duties, manage ED calls, document calls in the EMR, obtain records and facilitate transfers, organize charts, compile workers' compensation paperwork, monitor ED cafe supplies, and enter discharge disposition information into the ADT application.
Where assigned to Customer Information Center duties, initiate ED Code calls using the overhead paging system and online Code Log Book, answer after-hours CIC phone lines, and monitor alarm panels for incoming Codes.