PASC Cardiology Representative 9am - 5:30pm

Northeast Georgia Medical Center•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, collecting and verifying patient demographic and insurance information, confirming benefits and eligibility, obtaining pre-certification approvals, identifying and communicating financial responsibility, collecting applicable pre-service payments, providing financial counseling or referrals when appropriate, and completing pre-registration. The position supports scheduling for assigned areas, including Cardiology, and works with patients, Physician offices, insurance payers, and ancillary departments to ensure accurate, timely service.

Requirements

High school diploma or GED.
Ability to work independently, demonstrate emotional maturity, 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 areas, including procedures, diagnosis codes, and patient insurance details obtained from patients, Physicians, or surgery staff.
Identify available times for scheduled procedures 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.
Collect complete and accurate insurance information; verify coverage, eligibility, and benefits by contacting patients, Physician offices, and payers.
Follow standard operating procedures during ADT or system downtime.
Review patient history in Patient Access Systems to help avoid duplicate medical records.
Capture and document patient demographic, subscriber, guarantor, and insurance information, including relevant coverage and cost-sharing details, in the ADT system.
Review work for accuracy, particularly procedure, patient type, pavilion code, insurance, and demographic information.
As assigned, ensure scheduled and non-scheduled inpatient and outpatient accounts are authorized within organizational and payer guidelines, 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 in scheduling, pre-registration, and pre-certification.
Answer and manage incoming calls and meet department goals for outbound calls, answer speed, delays, AUX times, abandonment rate, and ACD time, while meeting customer service standards.
As assigned, review orders for accuracy and contact Physician offices about discrepancies or concerns.
As assigned, index and label faxed Physician orders promptly and efficiently.
Use applicable scheduling, pre-registration, insurance verification, estimation, electronic order, pre-certification, and phone quality-control systems appropriately.
Meet department goals, including productivity, accuracy, collections, and customer satisfaction.
Perform related duties and any additional department-specific duties assigned by management.