PASC Cardiology Representative 9am - 5:30pm

Northeast Georgia Health System•Gainesville, GA

About The Position

Under the supervision of the Patient Access Service Center Supervisor/Manager, the PASC Cardiology Representative delivers customer service while scheduling procedures and completing patient pre-registration. The role gathers accurate patient demographic, subscriber, and insurance information; identifies benefits, eligibility, and financial responsibility; obtains pre-certification approvals; and collects applicable payments or provides financial counseling. The position works with patients, Physician offices, insurance payers, and ancillary departments to support accurate and timely access to care.

Requirements

High school diploma or GED.
Ability to work independently, remain emotionally mature, and function effectively under stress.
Good communication skills and excellent written and oral communication skills.
Excellent problem-solving and analytical skills.
Ability to prioritize, organize, and coordinate daily workload.
Working knowledge of Protected Health Information.
Ability to manage change.
Detailed understanding of insurance guidelines and protocols, full verification components, and payer information and requirements.

Nice To Haves

Two years of previous hospital registration or business office experience.

Responsibilities

Enter scheduling information for assigned OR, Cardiology, and Radiology areas, including procedures, diagnosis codes, and patient insurance information.
Identify available procedure times and schedule promptly while allowing time for insurance verification and authorization.
Perform applicable medical necessity checks and complete ABN notifications when medical necessity requirements are not met.
Obtain and verify complete insurance information and confirm patient eligibility and benefits with patients, Physician offices, and payers.
Follow standard operating procedures during ADT or system downtime.
Review patient history in Patient Access Systems to avoid duplicate medical records.
Capture and document pertinent patient demographic, subscriber, and insurance details in the ADT system, including policy and ID numbers, subscriber and guarantor information, payer contact information, effective dates, copayments, deductibles, out-of-pocket amounts, coinsurance, and coverage percentages.
Review work for accuracy, including procedure, patient type, pavilion code, insurance, and demographic information.
As assigned, obtain authorization for scheduled and non-scheduled inpatient and outpatient accounts within organizational and payer time frames, and document pre-certification timely and appropriately.
Assess financial responsibility, communicate applicable liabilities before service, collect pre-service payments, explain the facility billing process, and refer patients for financial counseling when appropriate.
Work with Physician offices and ancillary departments to support patient satisfaction with scheduling, pre-registration, and pre-certification.
Perform related duties and additional department-specific assignments as directed by management.
Answer and manage incoming calls and meet department goals for outbound calls, speed to answer, delays, AUX time, abandonment rate, ACD time, and customer service.
As assigned, review accounts for order accuracy and contact Physician offices about discrepancies or concerns.
As assigned, index and label faxed Physician orders promptly and efficiently.
Use systems for scheduling, pre-registration, insurance verification, estimations, electronic orders, pre-certification, and phone quality controls.
Meet department goals for productivity, accuracy, collections, and customer satisfaction.