Patient Access Representative - Santa Monica (Part-Time)

UCLA Health•Santa Monica, CA

19h•Onsite

About The Position

The Patient Access Representative is responsible for pre-registering, pre-admitting, and admitting patients via telephone and in person. This role involves collecting accurate demographic information, reviewing and interpreting insurance benefits, obtaining prior authorizations, collecting cash, and interacting with public assistance programs like Medi-Cal and CCS. The representative will also implement Medicare requirements, liaise with physicians, office personnel, and other hospital staff, and refer patients to appropriate internal and external resources for discharge and post-hospital care. Additionally, they will collaborate with departments such as Utilization Review and Patient Business Services to ensure timely and accurate reimbursement.

Requirements

Knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS programs, out-of-state Medicaid, or other sponsoring agencies.
Knowledge in the functional operations of third party payers and utilization review agencies to expeditiously coordinate follow-up.
Working knowledge of third party payer verification terminology.
Working knowledge of medical terminology to sufficiently identify various procedures to obtain optimum benefit information.
Ability to accurately and completely process payments and cash receipts.
Ability to write concise, grammatically correct reports and correspondence.
Ability to type 55 words per minute (WPM).
Proficient in basic math.
Proficient in Microsoft Office Suite, specifically Excel, Word, and Outlook.
Must disclose if subject to any final administrative or judicial decisions within the last seven years determining they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.
Current/former UC employees are subject to a personnel file review.

Responsibilities

Pre-register, pre-admit, and admit patients by telephone and/or in person.
Collect accurate demographic information.
Review and interpret insurance benefits.
Obtain prior authorizations.
Collect cash payments.
Interact with public assistance programs (i.e. Medi-Cal, CCS).
Implement Medicare requirements.
Interact with physicians/office personnel as well as other hospital personnel (i.e., SDA, OPSU, nursing units).
Refer appropriate cases to other internal and external sources to assist patients with discharge/post-hospital care.
Interact with hospital departments such as Utilization Review and Patient Business Services to ensure correct and timely reimbursement.