Patient Access Representative I - OC

City of Hope•Irvine, CA

1d•Onsite

About The Position

The Patient Access Representative I is responsible for the check-in and check-out of patients on behalf of medical group physicians and other licensed providers. This role requires independent judgement in order to successfully coordinate the scheduling of patient appointments across multiple hospital departments. This individual is expected to utilize telecommunications and computer information systems to create accounts, verify information and insurance, collect co-pays, schedule and re-schedule complex appointments. The Patient Access Representative I is best defined as an independent and flexible resource that focuses on system-specific service lines that are in alignment with the patient experience initiative. Furthermore, this role must multi-task between different patient care areas to ensure an extraordinary patient experience and that quality standards are met. Additional duties include, but are not limited to: physician to patient communication and serving as an information resource.

Requirements

High School or equivalent
One year in a high-volume Customer Service related field with direct interaction with customers.

Responsibilities

Registers, pre-registers, consents and schedule all patient appointment types, across the clinics, ancillary areas and hospital.
Create pre-registration record and links pre-registration record to scheduled appointments.
Proactively coordinates appointments with other functional areas.
Maintains department productivity, accuracy, and quality assurance standards while performing these duties.
Ensure data is entered accurately for all patient demographic and insurance information.
Completes all required legal documents and obtains and scans all other related documents.
Performs cash collection functions, patient pricing estimates, ETC admission.
Ensures that financial protocols and requirements are met while providing access to service at COH facilities by reviewing account documentation.
Maintains and applies current knowledge of insurance requirements when verifying eligibility and confirms authorization is secured prior to forwarding patients to service delivery areas; escalates unsecure financial accounts to management.
Provides patients with itineraries, advance beneficiary notice and written instructions for tests and procedures as applicable.
Seeks assistance from Financial Counselors when needed to maintain patient flow while resolving financial issues and ensuring financial clearance of accounts.
Provides information and assistance to patients to ensure they understand the Financial Assistance policy and application process.
Provides Financial Assistance applications to all uninsured patients.
Screens ordered tests and communicate to physician and/or ABN Specialist those tests and/or diagnoses that do not meet criteria to be covered by Medicare.
Assures that the correct pre-registration visit encounter type is linked to the scheduled appointment.
Creates a request for authorization of service if applicable.
Send orders for diagnostic tests to appropriate department.
Assures that documentation indicating the date of service and the visit number accompanies the orders for diagnostic testing.
Ensure a high level of customer service by greeting, being a resource to patients and visitors.
Serve as a liaison between patients and support staff.
Develop effective relationships with colleague, physicians, providers, leaders and other employees across the organization.
Demonstrates genuine interest in helping our patients, providers and other employees by using excellent communication skills, being polite, friendly, patient and calm under pressure.
Managing multiple, changing priorities in an effective and organized manger, under stressful demand while maintaining exceptional service.
Maintain composure when dealing with difficult situations and responding professionally.
Independently recognize a high priority situation, taking appropriate and immediate action.
Effectively communicates with service delivery and other departments to resolve issues that impact patient care and escalating issues that cannot be resolved in accordance with departmental guidelines.
Maintains appropriate level of productivity and accuracy for work performed based on department standards.
Maintains thorough knowledge of policies, procedures, and standard work within the department in order to successfully performance duties on a day-to-day basis.
Performs other departmental duties as assigned, such as answering and making phone calls, managing incoming/outgoing faxes, organizing and filing departmental documents, inventorying supplies, data entry, etc.
Performs other related duties as assigned or requested.