Patient Access Rep II

Department:

10485 Revenue Cycle - PCC Patient Access

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

FTE - Monday-Wednesday 1pm - 11:30pm with rotating weekends. (4/10 hours shift/per week).

Major Responsibilities:

• Demonstrate superior skills in three of five areas of Patient Access. Proficiency will be demonstrated by being ranked as "exceeds expectations" in three key areas: quality of work (using measures for accuracy and completeness), patient satisfaction ( using measures in the area of friendliness, courtesy and ease of registration process), and efficiency (using measures related to timeliness of work, and work volume).
  •     1)Hospital Inpatient; the main admitting functions related to patients moving from ER or outpatient areas to bedded status as well as the processes of managing direct admissions
  •     3)Hospital Outpatient: The main outpatient registration areas of the hospitals, including but not limited to procedural areas and diagnostic testing areas.
  •     4)Pre-Access Scheduling: all areas under the scope of the scheduler job description.
  •     2)Pre-Access Insurance Verification: all areas under the scope of the Verifier job description
• When creating new registrations for walk-in patients, responsible for the identifying insurance coverage, the benefits available, patient out-of-pocket expenses, and collecting co-insurance and co-payments.
  •     1)Uses electronic systems to confirm coverage while patient is present and discussing the findings with the patient. Follow established department policies to resolve issues related to patient's eligibility for coverage or issues in in-network status for the patient using Advocate's network.
  •     2)When working uninsured patients, screen for urgent status cases and follow charity procedure. Refer as appropriate for additional financial counseling. Engage leaders to resolve questions on urgent versus non-urgent/elective care.
  •     3)When assisting walk-in patients, screen orders for compliance with policy. Work with physicians, Care Coordinators, and clinical department leaders to communicate and resolve issues related to order quality and acceptable standards.
  •     4)Collecting appropriate out of pocket expenses in accordance with policy.
  •     5)Screens physician orders against medical necessity criteria using compliance checker software. Follows procedures to obtain additional diagnosis information from physicians and initiates the Medicare Advance Beneficiary Notice of Non-Coverage to patients as appropriate.
• Responsible for performing all job duties in a way that conforms to our customer service philosophy and consistent with our "AIDET" standards
  •     1)Explain the nature of our work, why we ask for demographic, socio-economic, and financial information. Explain how we safeguard their information and use it to provide better care for them.
  •     3)Hand-patients off to the next area with a clear "thank you."
  •     4)Introduce the patient to our services, what they can expect while under our care. Utilize appropriate etiquette in all communications.
  •     2)Provide the patient with information on the likely time spent in the service area (duration) including time in registration and time in clinical service.
• Provides point of entry reception service in all Patient Access departments in order to create the highest levels of patient satisfaction, to minimize wait times, and to assist with patient throughput during the patient arrival process.
  •     1)Interacts with patients using AIM. Greets patients and families promptly and with courtesy, assisting with questions and directions.
  •     2)Begins financial clearance process by reviewing patient orders and confirming reason for patient visit verbally. Communicate discrepancies or questions to clinical partners. Obtain verbal/fax orders from physicians if needed. Ensure that complete narrative diagnosis and signatures are written on order.
  •     3)Partners effectively with ancillary units to facilitate patient arrival. Must b