Patient Access Representative, Full Time, 1st Shift

Virtua Health•Mount Laurel, NJ

18d•$20 - $30•Onsite

About The Position

At Virtua Health, we exist for one reason – to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between – we are your partner in health devoted to building a healthier community. If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment. In addition to five hospitals, seven emergency departments, seven urgent care centers, and more than 280 other locations, we're committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program, telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling. We're also affiliated with Penn Medicine for cancer and neurosciences, and the Children's Hospital of Philadelphia for pediatrics. Summary: Responsible for scheduling elective cases in scheduling systems accurately and completely to support operations’ needs. Responsible to ensure the completion of insurance verification, pre-certification, first party payment arrangements, pre-registration and point of service collection for all pre-scheduled inpatient, surgical, and high dollar outpatient scheduled cases via scheduling systems. Provide assistance to customer on financial counseling, price estimation on services and out of pocket costs. Verifying all insurance is correct in both the Patient Management and Patient Accounting systems to ensure an expedited registration process at the date of service and the production of a clean bill within the time frames set up by Virtua financial policies and regulatory guidelines to support the revenue cycle. Daily duties are performed to optimize the customer experience and provide an outstanding customer experience with every customer encounter.

Requirements

3 year minimum medical office or medical admittance experience preferably in a surgical or specialist office with an excellent understanding of third party reimbursement and methodologies for all third party payers especially pre-certification and COB regulations required or 3 year minimum at Virtua Patient Access department as a registrar who has demonstrated outstanding registration skills with strong insurance knowledge, and COB regulations.
Must demonstrate a positive demeanor, have both strong verbal and written communication skills.
Must be able to handle potentially stressful situations and multiple tasks.
Must have basic typing, computer and/or word processing skills.
High School diploma.

Responsibilities

Schedule elective cases in applicable scheduling system accurately and completely per established process flows and standard operation procedures to support operations scheduling needs.
Process all registrations accurately and timely for scheduled cases to ensure a clean bill which includes the following but is not limited to:
Accurately verifying and completing patient eligibility and insurance verification utilizing 3rd party sponsorship via phone and electronically which includes HDX, Navinet, Payor Sites etc.) in accordance with department policies and procedures.
Ensure CPTs are accurate for scheduled service, correct case status, validate and obtain proper precertification and referral is in place to ensure reimbursement.
Ensures coordination of benefits with multiple insurance payors.
Contacts physicians, their office staff and patient to obtain necessary information to complete pre-certification process.
Provides patients, physician offices, facility departments, and patient access campus registrars with explanation of insurance benefits, limitations and authorization guidelines.
Identifies and provides appropriate referrals and payment options to patients needed financial assistance and provides pricing to customers on Virtua services.
Completes full pre-registration per department policies and procedures in Patient Management system via phone with patient to expedite check-in at the date of service and to optimize the Virtua Customer Experience.
Correctly identifies, collects and processes co-pays, deductibles, co-insurance and deposits from patients and may facilitate resolution of billing issues by liaising with patient accounting, patient, and insurance representative with the ability to provide payment arrangements.
Understands and follows all patient access compliance and regulatory requirements for State, Federal which includes CMS.
Special projects and duties as determined by manager / supervisor to support the goals and objectives of the department.

Benefits

Virtua offers a comprehensive package of benefits for full-time and part-time colleagues, including, but not limited to: medical/prescription, dental and vision insurance; health and dependent care flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, colleague and dependent life insurance and supplemental life and AD&D insurance; tuition assistance, and an employee assistance program that includes free counseling sessions.
Eligibility for benefits is governed by the applicable plan documents and policies.
For more benefits information click here.

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