Job Description
Patient Access Representative
10 weeks Contract
San Francisco, CA 94118
The candidate must have at least 1-2 years of hospital registration experience. A degree is not required.
Under the general direction of the Supervisor and / or Manager of Patient Registration Services, this position is responsible for collecting and entering patient demographic and insurance information into the medical center's registration computer system. "These Principal Accountabilities, Requirements and Qualifications are not exhaustive but are merely the most descriptive of the current job. Management reserves the right to revise the job description or require that other tasks be performed when the circumstances of the job change (for example, emergencies, staff changes, workload, or technical development).
JOB ACCOUNTABILITIES
Service Standards: Consistently exhibits Service Standard behaviors set forth in the attached Service Performance Standards (see attached listing).
Productivity /Efficiency
Employees performing this job function will:
• Complete patient pre-admissions / registrations and admissions / registrations in accordance with PRS Department policies / procedures job aids in a timely and accurate manner (approximately 7 - 10 minutes for inpatients and 3-5 minutes for outpatients).
• Check the accuracy of registrations and correct errors by the end of their shift. The maximum acceptable daily error rate, for each Patient Registration Coordinator, is 5% or less for inpatients and 10% or less for outpatients.
• Note: Errors that are corrected by the Patient Registration Representative before the close of their shift will not be included in their daily error rate.
• Confirm insurance authorization for the following patient types, daily:
o Scheduled Admissions / ASU / SDC: Authorization for these patient types are usually provided by the Physician office. Visually inspect each admission order to confirm that the authorization is in place for the patient's scheduled procedure. Follow up with the Financial Counselor to notify the physician's office / insurance company to obtain authorizations that are not on file.
o Urgent / Direct Admission: Follow up with Financial Counselors to notify and obtain authorizations within 24 hrs of admission, from applicable insurance carrier.
Note that this process may require coordination with the Clinical Resource Management (CRM) personnel.
• Answer patient questions regarding the Patient Bill of Rights, Medicare Bill of Rights, HIPAA and ABN. Obtains patient signatures when applicable (e.g. consent forms and Notice of Privacy acknowledgement form).
• Comply with Government, Medical Center, and Sutter Health Policies and Procedures at all times.
Technical Skills
This position requires the following skills:
• Must be able to interview patients / family to obtain the required patient and guarantor demographic and insurance information.
• Must be able to accurately and efficiently enter this information into the Patient Registration system.
Communication
The following are the required communication skills for this position:
• Must demonstrate effective and sensitive communication with patients, physicians, other customers and co-workers as measured by no legitimate patient / other complaints per year. As needed validate that the patient understands the information and instructions you are providing.
• Will maintain accurate and thorough account comment documentation in the Patient Financial System.
• Must be able to explain financial requirements to patients / guarantors; coordinate patient registration and insurance information with the ancillary departments. This includes communicating referrals for financial assistance or Medi-Cal.
Quality
This position must be able to perform:
• Inpatient Admission with a 95% accuracy rate.
• Outpatient Registration with a 90% accuracy rate.
• Be willing to cross-train in other areas as needed / requested
CPMC Citizenship
The employee in this position will:
• Adhere to all Medical Center policies and procedures (i.e. Administrative and Human Resources), practice safe work habits, and engage in good business standards and practices.
EDUCATION
Equivalent experience will be accepted in lieu of the required degree or diploma.HS Diploma or equivalent education/experience
PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN:One year of prior hospital or medical registration experience.
SKILLS AND KNOWLEDGE
High-level knowledge of Government regulations and requirements, managed care contracts and third party requirements.
Demonstrated knowledge of the PRS and medical office / hospital admission processes.
Basic knowledge of medical terminology
Excellent English communication skills in both written and verbal formats.
General understanding of Patient Registration Systems
Completed a minimum of the Microsoft Level 1 classes in Outlook , or be able to pass the PFS proficiency exam - level 1.
JobDiva 25-36381
Best Regards
Ajeet Kumar - Team Lead - IT Recruitment
Direct: / Desk : Ext.7790
10 Exchange Place, Jersey City, NJ 07302, USA
About US Tech Solutions:
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