Patient Access Services Representative - Outpatient Scheduling - Full Time - Bilingual (English/Spanish) Preferred

Kern Medical • Bakersfield, CA

5d • $21 - $31

About The Position

Under supervision, performs patient access, registration/admitting, and financial counseling activities. Assignments may involve patient pre-registration and registration, admitting, financial counseling, or related patient access areas. The representative is expected to develop specific knowledge of patient and insurance demographic information and available payment options. This is the first level in the Patient Access Services Representative classification series and is distinguished from Representative II by the complexity and responsibility of assignments. Promotion to Representative II is based on department head recommendation and approval of the Director of Personnel.

The role includes greeting patients, reviewing processes, scheduling appointments, assembling registration documents, completing insurance verifications and authorizations, entering information into the hospital EHR and other applications, assessing and collecting patient financial responsibility, and screening patients for potential eligibility for government funding or financial assistance. The representative also provides information about payment policies and available funding resources, works with revenue cycle teams to resolve issues, maintains fiscal records, and responds to patient access inquiries.

Employees must maintain health requirements designated by Kern Medical. A background check may be required. Kern Medical employees are designated Disaster Service Workers and may be required to remain at or report to work during a disaster or civil disorder when safe and practicable. A valid California driver's license and compliance with the applicable vehicle-use policy are required if assigned duties require driving.

Requirements

• High school diploma or GED and six months of patient access experience, or an equivalent combination of education, training, or experience sufficient to perform the essential duties.
• Knowledge of state and federal government funding programs, including Medicare, Medi-Cal, CCS, TRICARE/CHAMPUS, and Workers' Compensation, as well as commercial insurance payers.
• Knowledge of billing and reimbursement guidelines and methodologies for government and non-government payers, medical and insurance terminology, and HIPAA privacy and compliance practices.
• Ability to communicate effectively orally and in writing; read, understand, and apply policies and guidelines; and obtain information from patients, families, and other sources.
• Ability to use computers and software, establish effective working relationships with patients, families, and other customers, and work with tact and empathy in stressful situations.
• Ability to work effectively with frequent interruptions, perform multiple tasks in a fast-paced environment, lift, carry, push, or pull files, sit at a workstation for prolonged periods, and report to various hospital departments.
• Maintain all health requirements designated by Kern Medical.

Nice To Haves

• Customer service and registration experience in a clinic setting or medical office is preferred.
• Bilingual English/Spanish is preferred.

Responsibilities

• Greet patients, explain processes, and schedule examination or follow-up appointments.
• Assemble data and documents needed for patient registration, including pre-admission, admission, pre-registration, and registration; complete insurance verifications and authorizations.
• Enter patient demographic information into the hospital's EHR and use other department applications for eligibility and authorization.
• Assess patient financial responsibility and collect applicable co-pays, co-insurance, out-of-pocket amounts, share of cost, or deductibles at admission.
• Screen admissions and inform referring physician offices, patients, and families about hospital payment-source policies and procedures.
• Interview patients at a workstation or bedside to determine possible eligibility for state-funded programs.
• Obtain and document patient funding information, explain available funding resources, and obtain funding for patients at assigned stages of the access process.
• Use payer resources and websites to assess eligibility; initiate referrals for Medi-Cal, CMS, CCS, and KMCHP; and apply the KMC Financial Assistance Policy and Procedures to determine eligibility for discounted prices or charity care.
• Collaborate with revenue cycle departments to identify and resolve issues or barriers.
• Enter fiscally related information into databases and maintain fiscal records and files.
• Respond to inquiries about patient access processes, policies, and related information; research and resolve customer problems.
• Perform other related duties as assigned.

Benefits

• New hire premium of 6% of base pay, matched up to 6% if contributed to the Deferred Compensation Plan.
• Shift differential pay, varying by classification.
• Comprehensive benefits package including holidays, paid time off, retirement, medical, dental, vision, and life insurance.
• May be eligible for participation and company contributions into the Kern County Employees’ Retirement Plan.
• Additional compensation may be available through differentials, incentives, and bonuses.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED