Pontiac, Michigan, USA
54 days ago
Patient Access Representative
Employment Type:Part timeShift:Rotating Shift

Description:

   I             Accountability Objectives:


 

      Responsible for performing the Patient Access process, completing accurate registration and pre-registration process


 

      and insurance verification for eligibility, scheduling for various departments procedures/appointments, entering patient


 

      data for services for departments participating in PHS (Pathways Healthcare Scheduling), coordinating multiple


 

      services in proper sequence, and informing patient/doctor's office as to preparations and insurance requirements for each


 

       service.  Collaborates with multiple departments to best utilize equipment and facilities, while accommodating


 

      physician preference and patient needs. Displays a courteous, professional manner, proactively developing customer


 

      relationships and giving high priority to customer satisfaction.


 

   II            Position Qualifications:


 

   Minimum Education, Licensure / Certification and Experience Required.


 

   A.      Education


 

                  High school diploma or GED or equivalent required.


 

                  Courses in word processing and medical terminology preferred.


 

                  College classes in a business, public relations, or medical field concentration preferred.


 

   B.      Licensure / Certification


 

                  National Association of Healthcare Access Management certification preferred within one year of start date,


 

                  and maintains certifications.


 

   C       Special Skill / Aptitudes


 

                  Ability to type 30 wpm and familiarity with computer systems and applications required.


 

                  Ability to pass the basic medical terminology test with a passing grade.


 

                  Completion of Patient Management Registration Course and Pathways Healthcare Scheduling Course with at


 

                   least an 85% grade on the final exams prior to receiving access codes within 90 days of start date.


 

                  Strong interpersonal skills necessary to provide scheduling and registering patients and to clearly


 

                  communicate with a variety of customers of all ages and cultures.


 

                  Ability to work independently, organize tasks, problem solve, and devise acceptable solutions in a fast paced


 

                   work environment.


 

                  Ability to simultaneously gather verbal information through the use of the telephone and enter data into an


 

                  on-line computer terminal.


 

                  Excellent customer service orientation  skills necessary in order to deal effectively with various levels of


 

                  hospital personnel, outside customers and community groups.


 

   Minimum Education, Licensure / Certification and Experience Required.


 

   D.      Experience


 

                  One year work experience related to patient registration, insurance verification, and/or medical terminology


 

                  required, normally gained by working in a hospital or physician's office setting including customer


 

                  interaction service OR


 

                  6 months emergency services experience related to patient registration, insurance verification, and/or medical


 

                  terminology required.


 

                  One year experience with ICD-9-CM and CPT coding as a Registrar or Patient Access Professional preferred.


 

   III          Duties / Responsibilities:


 

      1          Interviews the patient / family for admission and outpatient registration by entering the appropriate required


 

                  information on-line. This will include, but is not limited to: demographics, clinical, and detailed insurance


 

                  information


 

      2          Performs insurance eligibility verification by phone or on the Internet.


 

      3          Independently schedules procedures for all departments and any subsequent departments added to Pathways,


 

                  utilizing individual departmental grids, resources and guidelines.


 

      4          Determines if authorization is required for the patient's service and secures authorization for


 

                  treatment/procedures prior to service being rendered.


 

      5          Determines an understanding of hospital policies, prevailing regulatory and third party requirements (MSP


 

                  questionnaire, pre-certification process, consent forms, etc.)


 

      6          Recognizes and problem solves conflicts associated with time requests, resources, equipment or staff for each


 

                  department.


 

      7          Coordinates multiple hospital services such as surgical procedures, ancillary testing, etc., in proper sequence


 

                  and according to the rules of the system, which may include managed care requirements and clinical


 

                  standards.


 

      8          Refer patients with no insurance or outstanding balances to the Financial Counselor.


 

      9          Informs patients or doctors' offices of preparations for appointments made.


 

      10         Works independently to problem solve scheduling issues and troubleshoot/report system problems.


 

      11         Maintain uninterrupted scheduling service utilizing down-time procedures.


 

      12         Provides daily reports or printouts as directed while maintaining the confidentiality of patient records and


 

                  information at all times.


 

      13         Utilizes excellent customer service and telephone courtesy skills in all interactions with customers.


 

      14         Attends meetings, participates in Continuous Quality Improvement.


 

      15         May perform clerical tasks specific to supporting an assigned department(s)  i.e., receptionist duties, charge


 

                  capture, report processing and delivering, copying, filing, etc.


 

      16         Performs other duties as assigned.


 

      17         Demonstrates and actively promotes an understanding and commitment to the mission of St. Joseph Mercy


 

                  Oakland through performing behaviors consistent with the Trinity Health Values.


 

      18         Maintains a working knowledge of applicable Federal, State, and Local laws and regulations, the Trinity


 

                  Health Organizational Integrity Program, including the Standards of Conduct, Code of Ethics, as well as


 

                  other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and


 

                  professional behaviors.


 

      19         Supports and conducts one's self in a manner consistent with customer service expectations.


 


 

      20         In accordance with unit or departmental practice, determines that appropriate charges have been entered for the


 

                   correct patient, encounter, date/time of service, with any required modifiers.  Make corrections as needed per


 

                  charge capture policy/practice.


 

      21         In accordance with unit or departmental practice, actively participates in on-going education and


 

                  communication regarding revenue management.


 

      22         In accordance with unit or departmental practice, assists with tracking and monitoring of equipment assigned


 

                  to the unit.  Requests services for maintaining equipment as needed.


 

      23         In accordance with unit or departmental practice, proficient with the electronic health records for


 

                  documentation, assessment, and care management, performing these activities concurrently with provision of


 

                  care throughout the shift.

Our Commitment to Diversity and Inclusion
 

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

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