Oncology Patient Access Representative III

Sutter Health•Oakland, CA

1d•$37 - $52

About The Position

The Oncology Patient Access Representative III obtains the information needed to register and financially clear patients and oversees registration information for efficient and accurate processing across Emergency, Ambulatory, Inpatient, and Outpatient service areas. The role provides functional guidance to new employees, resolves problems, supports EHR compliance, and contributes to continuous improvement in Patient Access processes and services. The representative gathers and verifies patient demographic, clinical, financial, and insurance information; completes registration and financial clearance; processes physician orders; maintains work queues; verifies insurance eligibility and benefits; and explains and collects patient financial liability. The position also supports patients and families, refers appropriate cases to financial counseling, and may perform cashiering, bed management, and communications operator duties. The role reviews and clears EHR and ADT work queues, corrects registration and billing errors, supports timely reimbursement, provides feedback and education to Patient Access staff, and creates workflow tip sheets and service tickets. It works collaboratively with Patient Access, clinical leadership, and Sutter affiliates to resolve account and system issues. This is a regular, full-time, non-exempt position with a day shift schedule, Monday through Friday, eight hours per shift, and occasional weekend requirements.

Requirements

High school diploma or GED.
Two years of recent relevant experience.
General knowledge of patient access and financial counseling functions in acute and non-acute settings.
Working knowledge of insurance and medical terminology.
Knowledge of EMTALA and consent laws.
Time management skills and ability to manage frequent in-person patient contacts while accurately maintaining and documenting data in patient registration systems.
Ability to work accurately and efficiently in multiple computer systems, including registration and accounting systems, telephone consoles, document imaging and scanning, payment posting, payer websites, and data quality monitoring tools.
Verbal and written communication and active listening skills.
Accuracy and attention to detail.
Decision-making and problem-solving skills.
Ability to work concurrently on multiple tasks and projects in a diverse environment.
Ability to meet or exceed targeted customer service, productivity, and quality standards.
Computer proficiency.
Ability to work with and maintain confidential information.

Responsibilities

Greet patients and family members and obtain or verify demographic, clinical, financial, and insurance information for patient registration and financial clearance.
Enter patient and guarantor information into registration and accounting systems; obtain signatures on required forms and image or copy registration documents.
Authenticate and register patients who have registered through the Patient Access Center, and complete end-to-end registration and close-out for patients who have not.
Obtain and process signed physician orders.
Maintain assigned work queues.
Conduct insurance eligibility and benefit verification, referral and authorization processes, and financial education on designated accounts.
Calculate estimated patient liability, inform patients or guarantors, collect appropriate payments and deposits, and process payments for current or prior services.
Refer appropriate cases to financial counseling for follow-up and consultation.
Perform other assigned duties, which may include cashiering, bed management, and communications operator work.
Provide a positive patient experience through face-to-face and other communications, demonstrating knowledge of Sutter Health systems and services.
Support the implementation of Shared Services programs, policies, initiatives, and tools, and contribute ideas for improving Patient Access processes.
Seek and respond to regular performance feedback from the team lead and provide upward feedback as needed.
Maintain positive working relationships across Shared Services teams and support peer relationships within the Patient Access Client Location Team.
Perform revenue cycle tasks that support compliance and customer service, authenticate patient identity, and provide directional assistance to patients and families when needed.
Maintain knowledge of applicable laws, regulations, standards, and Sutter policies and procedures, and meet the department's monthly cash goal.
Review EHR work queues, resolve ADT issues, provide technical support, and clear hospital billing work queues.
Identify and correct errors preventing insurance billing, release and correct work queue errors, and support efficient and timely reimbursement.
Work with Patient Access and clinical department leadership and other appropriate parties to resolve accounts and ensure proper billing.
Correct and log registration errors and notify Patient Access Management when error rates exceed the permitted standard.
Provide error feedback and education to Patient Access staff and create workflow tip sheets as needed.
Create and track system workflow service tickets for EHR improvements, implementations, troubleshooting, and patient chart corrections.
Collaborate with Sutter affiliates to identify and explore resolutions for service tickets.