Oncology Patient Access Representative III

Sutter Health•Oakland, CA

1d•$37 - $52

About The Position

Obtains the information needed to register and financially clear patients, and serves as a resource to new employees by providing functional guidance, resolving problems, and using sound judgment and initiative as workflow requires. Supports continuous improvement in business processes and services, identifies and resolves issues, and provides technical support to promote desired outcomes and compliance with the Electronic Health Record (EHR) and Sutter Health policies and procedures. Oversees registration information collected during workflows for Emergency, Ambulatory, Inpatient, and Outpatient services related to hospital billing and compliance. The role greets patients and family members; obtains and verifies demographic, clinical, financial, and insurance information; enters patient and guarantor details in registration and accounting systems; obtains signatures; and images or copies registration documents. It authenticates and registers patients, processes physician orders, maintains work queues, verifies insurance eligibility and benefits, handles referrals and authorizations, provides financial education, estimates patient liability, and collects or processes payments. It refers appropriate cases to financial counseling and may perform cashiering, bed management, and communications operator duties. The representative promotes a positive patient experience through in-person and other communications. The role supports Patient Access programs, policies, initiatives, and tools; contributes to process improvements; seeks and responds to performance feedback; and maintains positive working relationships across teams. It performs revenue-cycle tasks, authenticates patient identity, may provide directions, follows applicable laws and Sutter policies, and meets the department's monthly cash goal. EHR responsibilities include reviewing work queues, resolving Admission, Discharge, Transfer (ADT) issues, clearing hospital billing queues, identifying and correcting errors that prevent insurance billing, releasing and correcting queue errors, and working with Patient Access and Clinical leadership and other appropriate parties to resolve and properly bill accounts. The representative logs registration errors, notifies management when error rates exceed standards, provides staff feedback and education, creates workflow tip sheets as needed, tracks system service tickets for EHR improvements and troubleshooting, and collaborates with Sutter affiliates on ticket resolutions. This is a per diem/casual position with day shifts, variable days, eight-hour shifts, and every-weekend requirements. The posted pay range is $36.83 to $51.55 per hour. Benefits are listed as unavailable for this position.

Requirements

High school diploma or General Education Diploma (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 the Emergency Medical Treatment and Active Labor Act (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.
Demonstrated ability to work accurately and efficiently across multiple computer systems, including patient registration/accounting systems, telephone consoles, document imaging, scanning, payment posting, payer websites, and data-quality monitoring systems.
Verbal and written communication and active listening skills.
Accuracy and attention to detail.
Decision-making and problem-solving skills.
Ability to work concurrently on varied tasks and projects in a diverse environment.
Ability to meet or exceed 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 in registration and accounting systems; collect signatures and image or copy registration documents.
Authenticate and register patients who have registered through the Patient Access Center, or complete the registration process through close-out for other patients.
Obtain and process signed physician orders.
Maintain assigned work queues.
Verify insurance eligibility and benefits, process referrals and authorizations, and provide financial education on designated accounts.
Calculate estimated patient liability, inform patients or guarantors, collect copayments, deductibles, and deposits, and process payments, including payments for prior services.
Refer appropriate cases to financial counseling for follow-up and consultation.
Perform other assigned duties, including cashiering, bed management, and communications operator tasks.
Enhance the patient experience and demonstrate knowledge of Sutter Health's system and services during patient interactions.
Support implementation of Shared Services programs, policies, initiatives, and tools, and contribute to continuous improvement of Patient Access processes.
Learn new processes and skills, seek and respond to performance feedback, and provide upward feedback as needed.
Maintain positive working relationships with other Shared Services teams and support strong peer-to-peer relationships.
Perform revenue-cycle tasks, authenticate patient identity, provide directional support when needed, follow applicable laws and policies, and meet the department monthly cash goal.
Review EHR work queues, resolve ADT issues, and provide technical support in compliance with EHR and Sutter Health policies and procedures.
Clear ADT hospital billing work queues and identify and correct errors preventing insurance billing.
Release and correct work-queue errors to support efficient, timely reimbursement.
Work with Patient Access and Clinical 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 allowed standard.
Provide error feedback and education to Patient Access staff.
Create workflow process tip sheets to improve registration and revenue processes 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 to help tickets.