Patient Access Rep I (On Call) Clackamas, OR
The Patient Access Representative I is a unique role within the Kaiser Permanente Health System environment. The Patient Access Representative I welcomes the patient into the care delivery setting and initiates the administrative systems that will lay the groundwork for the patient's clinical care as well as the financial documentation.
- Registration: Greets and registers patients for various medical services in the hospital setting potentially in a 24 hour, 7 day a week environment and in a highly active fast paced setting such as the Emergency department. Pre-registers patients where applicable.
- Completes comprehensive bedside or telephone interviews with Patient, relative, or their representative to obtain pertinent demographic information, insurance data and/or third party liability information.
- Performs minimal eligibility verification and resolves discrepancies as able or defers to appropriate resource, identifies need for financial assistance recommendation and application, referring to the Financial Counselor where necessary.
- Revenue Collection: Determines and collects cost-shares, and partial payments for services to be received. Enter/verify payments in the computer, close cash drawers, count currency, checks, and credit card payments at the end of each shift, and create deposits per cash handling policies.
- Provides patient liability information and collects the point of service cash from patients based on guidelines and/or systems provided by the department, including but not limited to: co-payments, deductibles, co-insurance, deposits, and outstanding balances
- Communicate to the patient the Northwest's policy on payment of services or prepayment when significant patient liabilities are identified.
- Appointing: May schedule and/or cancel right type of appointment based on member's needs and regional protocol.
- If applicable, makes return appointments.
- Regulatory/Organizational Compliance: Completes regulatory or policy required forms, to include payor requirements such as Medicare, L & I requirements and some commercial payors, and obtains all necessary signatures via mail, pre-admit, pre-op visit or upon admission/registration.
- Makes copies of patient identification, insurance information and other related forms and documents, electronically scan capture where appropriate.
- Understands and adheres to the rules and regulations of Medicare, Medicaid, Managed Care and Commercial payers regarding referrals, preauthorization and pre-certification requirements.
- General Services: Stocks appropriate forms and supplies; takes out used supplies. Demonstrating responsibility in handling supplies and equipment in a cost-effective manner and according to standards such as policies, procedures, and infection control guidelines.
- Assist patients by providing specialty phone numbers, facility directions and office layouts; directing to other departments and administrative services for further information, for example (but not limited to) Membership Services, Dental and Pharmacy.
- Escorting patients to area of service
- Performs all other duties as assigned consistent with job description.
- This job description is not all encompassing.
- One (1) year healthcare financial AND one (1) year office environment customer service OR two (2) years post high school related education OR combination of education and experience.
- Previous experience with cash handling required.
- High school diploma/GED.
- Must obtain training and Medical Terminology certificate within 180 days if existing Patient Access Employee or has proof of completed Medical Terminology course, outside applicant must have upon hire.
- Obtains training and becomes CPR Certification within 30 days if existing Patient Access Employee or has proof of current CPR Certification, outside applicant must have upon hire.
- Ability to type minimum 35 wpm with above average accuracy.
- Excellent communication skills with all types of individuals.
- Excellent organizational and written skills, flexibility and ability to switch tasks frequently.
- Ability to operate CRT, IBM compatible PC, Windows, such as MS Word/Excel, copier, fax, phone, and headset.
- Job requires continuous reading skills and the ability to handle a heavy volume of work.
- Working knowledge of basic medical terminology, diagnostic related groupings, diagnosis and common procedure terminology to determine benefits and estimate service cost.
- Knowledge of Medicaid, Medicare, and other government and insurance/payor requirements.
- Knowledge of basic State and Federal regulations governing healthcare encounters, such as HIPAA, State worker's compensation, third party liability for accidents, EMTALA and etc.
- Knowledge of and skill in the use of automated Patient care systems for admissions, registration, and basic medical records functions (registration systems).
- Knowledge of basic state and federal regulations regarding funding resources.
- Knowledge of organization's and/or facility based billing systems.
- Knowledge of department procedures and established confidentiality policies.
- Knowledge of communication techniques with ability to listen actively and respond to fellow employees/customers in a timely, competent manner both verbally and non-verbally.
- Previous experience with EPIC applications preferred.
- Previous hospital or ambulatory clinic registration experience preferred.
- One (1) year higher education preferred.
- Certification by HFMA or NAHAM preferred.
- Obtains training to become a Certified Healthcare Access Associate by the National Association of Healthcare Access Management within 180 days of employment preferred.
Primary Location: Oregon,Clackamas,Kaiser Sunnyside Medical Center 10180 SE Sunnyside
Scheduled Hours (1-40): 1
Working Days: Variable
Job Type: Standard
Employee Status: Regular
Employee Group: SEIU - Local 49
Job Level: Individual Contributor
Job: Customer Services
Public Department Name: Patient Access Business Services
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
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