SUMMARY
The Pre-Access Representative will be responsible for handling the flow of scheduling calls. The essential responsibilities include pre-registration, scheduling, obtaining accurate demographics, providing exam preparations, and collection of appropriate authorizations/ICD codes in a courteous and efficient manner. They will be responsible for completing accounts with eligible insurance and authorization and complete patient pre-registration for scheduled procedures. The Representative will verify the patient payer eligibility, benefits/coverage, and estimated payment responsibility, confirm authorization requirements and secure on the account. The Representative will complete pre-registration phone interviews, to include obtaining necessary pre-registration information, including demographics, insurance information, and Medicare MSPQ, with documentation completed in the electronic medical record account. During the pre-registration interview, the representative will notify patient of potential financial responsibility and collect payment via phone, review issued Medicare ABN (Advance Beneficiary Notification), provide direction to facility and registration desk, and educate the patient regarding what items are required as part of the patient's facility registration process.
STATUS: FULL-TIME
LOCATION: SLH MARKET 201 Market Street - Potsdam, NY 13676
DEPARTMENT: COMMUNICATION CENTER
SCHEDULE: MONDAY - FRIDAY 8:30AM-5PM
RESPONSIBILITIES:
Scheduling Procedures:
Answers phones from patients/customers professionally and responding to patient/ customer complaints.
Performs correct name inquiry and identifies patient according to policy and procedure without errors
Schedules patients/customers based on scheduling guidelines and medical appropriateness.
Receives a high volume of inbound calls with varying degrees of questions and concerns.
Obtaining and collecting all necessary information from the patient/ customer to schedule and register the patient for an appointment.
Consults with referring physician’s office to ensure written and/ or electronic orders exist and obtain them as needed.
Collects patient financial data, insurance, authorizations, and reference numbers.
Collects complete demographic information of patient including address, phone number.
Collects medical information to include patient complaint
Revenue Cycle:
Views insurance card(s) and scans into computer system reviewing for mandatory precertification and/or other third party payer requirements
Obtains Inpatient/ Observation patients precertification’s
Re works accounts to ensure accurate patient statuses
Collects complete financial information to include payer name, identification number, group number, subscriber name, guarantor name and address, and precertification numbers
Selects appropriate financial class and insurance code
Performs online real-time eligibility verification and registration scrub via AHIqa and makes changes to registration errors accordingly and in a timely fashion
Screens for insurance edibility via insurance websites, where appropriate
Completes Medicare Secondary Payer Questionnaire for all Medicare-eligible patients
Completes all admission forms required by Medicare
Verifies third party payer benefits and Worker’s Compensation according to departmental policy and procedure
Collects any patient-pay balances such as copay, co-insurance, or deductible at time of registration
Refers patient to Patient Financial Advocacy Program when appropriate and per departmental procedure
Balances cash draw, completes cash receipt, issues patient receipts and secures safe daily with no exceptions
Registration/Pre-Registration:
Interviews the patient and/or family member either in person or by telephone to collect demographic, financial, and medical information
Performs correct name inquiry and identifies patient according to policy and procedure without errors
Collects complete demographic information of patient including address, phone number, and employer
Collects medical information to include patient complaint
Explains consent information, obtains signatures, witnesses (legibly) with no omissions
Obtains copy of patient identification document(s)
Completes registration process within five minutes for preregistered patients and ten minutes for non-preregistered
Contacts physician offices to obtain and confirm patient information
Customer Service
Practices proficient customer service skills by greeting and treating all patients and staff with respect and discretion
Capable of empathizing with the circumstances of patients and families while maintaining and objective approach to the disposition of each account
Provides and explanation of any patient wait and responds to all patient requests. Notified manager of any patient wait times longer than 15 minutes.
Greets each patient and identifies self by name and role
Notifies the manager of incidents, errors or patient complaints
Maintains patient privacy and confidentiality at all times according to established procedures
Assess environment for safety hazards, which could harm patients, visitors, or other hospital employee’s and reports any found to facilities/housekeeping/manager
Exhibits professionalism in appearance, speech and conduct
Development:
Provide orientation and training of new staff
Attend Patient Access Meetings, Training Sessions, etc
Attend and actively participate in required and voluntary in-service education
MINIMUN QUALIFICATIONS
PREFERRED QUALIFICATIONS
Associate’s degree or higher in healthcare administration, business administration, or related field desired
At least 1-3 years of customer service, administrative, and/or data entry experience preferred
One to two years of previous experience in hospital related field preferred
Experience with database software applications desired
UNION:
1199-200B SEIU (CPH) Clerical
Note: Not all per diem roles are union eligible
EDUCATION:
LICENSES / CERTIFICATIONS:
PHYSICAL REQUIREMENTS:
S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.
Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.
PAY RANGE:
$19.46 - $28.55
The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.
Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.
