Access Service Representative II - Rehab Business Services - Sharp Grossmont Hospital for Neuroscience - Full Time - Day Shift

Hours:

Shift Start Time:

8 AM

Shift End Time:

4:30 PM

AWS Hours Requirement:

8/40 - 8 Hour Shift

Additional Shift Information:

Weekend Requirements:

No Weekends

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$24.750 - $30.860 - $36.970

 

This position is covered by a Collective Bargaining Agreement (CBA) with SEIU-UHW. As part of the terms of employment, employees in this role are required to join the union within 31 days of hire and remain a member (e.g. dues paying, fee paying, religious exception contributor) for the duration of the collective bargaining agreement.

What You Will Do
The role of this position is to coordinate the continuity of services required during the patient's episode of care in Outpatient Rehabilitation. This includes but is not limited to: ensuring orders and authorizations are obtained timely prior to initial scheduled visit and all regulatory documents are obtained and signed by M.D. prior to scheduling any continued visits outlined in the therapist POC. This position will be the main contact and interface between therapist, patients and MD offices, for all patients in assigned specialty programs, during their course of treatment. Including the processing of clean accounts to ensure maximum financial reimbursement.

Preferred Qualifications

• 3 Years Experience in a hospital patient registration, accounting and/or business services area
• AHA Basic Life Support for Healthcare Professional (AHA BLS Healthcare) - American Heart Association -PREFERRED

Essential Functions

• Admissions
  * Accurately completes all functions, at point of registration. Complies with all rules and regulations governing Medicare and Medi-Cal billing.
  * Verify accurate demographic and visit data ensuring no duplicate registrations.
  * Complete and accurate insurance selection and follow-up questions.
  * Insurance/Physician/Therapist notification – documented.
  * Dissemination of admission forms – Address Attestation, Attendance Policy, Financial Agreements, HMO Agreements, Tricare,
  * Medicare Secondary Payers, and Self Pay obtaining required signatures.
  * Check for MCARE overlapping charges for all accounts.
  * Any additional functions as described in Department memos or general updates, including assisting with prebilling functions as assigned.
  * Assures billing compliance standards are met.
  * Check DDE for Medicare eligibility.
  * Urgent admissions are verified and authorized immediately or upon next business day.
  * Ensure prescription with diagnosis is available prior to first scheduled visit.
  * System re-admitted accounts are organized, transitioned, and verified.
• Scheduling
  Scheduling appointment from initial evaluation to the end of care. This may consists of varying scenarios based on the patient’s referral for services. Employee must understand the bases of scheduling and ensures compliance with various insurance regulations, CMS requirements and CA State Licensing within these regulations and needs of the patient as it applies to various scheduling scenarios.
  * Single disciplinary
  * Cross disciplinary (multi therapies)
  * Cross Program
  * Cross Therapist licensure
  * Coordination of Transportation Services
• Finance and billing
  * Works timely, all bill holds on patient accounts that appear in ETM for assigned program.
  * Alerts manager, ensuring all coding is applied to accounts to ensure clean bill drop.
  * Ensures UB coding is completed, post evaluation, on all accounts requiring this information to bill.
  * Makes financial arrangements with patients who have self-pay accounts, co-insurance and co-payments.
  * Collect and reconcile co-payment batches before submission.
  * Audits charges for all disciplines for accuracy. Upload charges across the interface. Works/clears TES edits.
  * Follows Medicare guidelines for CAP Threshold dollars met and KX modifying accounts.
  * MPV is used with every accounts along with insurance portals to verify eligibility.
  * Performs billing functions accurately and efficiently. Problem solves error reports received, and corrects errors as necessary.
• Leadership
  * In conjunction with leadership, assures complete and accurate patient registration and helps identify areas for improvement and positive reinforcement.
  * In the absence of leadership, performs the leadership functions required to maintain departmental coverage and operations within established policies and guidelines.
  * Informs Leadership of special occurrences and/or staff issues in a timely manner.
  * Assists