Patient Access Representative CCC Full Time Days

Desert Regional Medical Center is a 385-bed acute-care hospital classified as a stroke receiving center and level 2 trauma facility with an innovative, patient centered and evidence-based Rehabilitation Services Department.  Our compassionate team provides a wide range of inpatient and outpatient services, including acute care rehabilitation, joint replacement & spinal surgery, neurosurgery, ICU, Telemetry, step-down care, skilled nursing, as well as outpatient therapy, hand and lymphedema clinics.

Summary

To process new and return patient registrations for outpatient procedures; complete registration for new patients upon appointment arrival; update demographic and insurance data of established patients; verify insurance benefits for timely reimbursement from federal and state intermediaries and contracted commercial payers; ensure the accuracy and integrity of patient demographics and insurance data in the information systems.

These services further the vision of Desert Regional Medical Center to create unique environments, where patients, their families, doctors and staff come together to achieve longer and better lives in the fight against cancer.

DEPARTMENT SPECIFIC DUTIES:

Process pre-registration forms by entering demographic and insurance data in the information systems, verifying insurance benefits to validate policy coverage and reimbursement, creating patient financial folder for pre-registration documents filing, insuring all necessary demographic and insurance information are captured on the pre-registration form in preparation of new patient appointment arrival.

Complete the registration process for new patients upon arrival by obtaining the required signatures on the following forms: Conditions of Admission, Assignment of Benefits, Medical Release, Medicare Screening, Arbitration agreement, and providing Patient Rights/Responsibilities and Your Right To Make Decisions About Medical Treatment. This also includes photocopying the patient’s identification and insurance card(s), validating demographic and insurance information for accuracy, updating any discrepancies in the information systems, ensure attendance of the registration appointment schedule, submit appropriate authorizations and ensure authorizations/pre-certs are received prior to services rendered.

Process patient registration update forms and other related documentation by updating the information systems, verifying insurance benefits and notifying the appropriate departments of changes.

Review system reports to discharge accounts and create new accounts for discharged accts. Maintain and update the SMS insurance and Doctor Master list. Trouble shoot and relay computer issues to supervisor.

Coordinate and manage patient flow in the department by providing directions and general information to patients.

WORKING RELATIONSHIPS

Outside contacts: Interaction with patients and their family members. Interaction with insurance carriers, referring Physicians, Physician office staff and Hospital admitting staff.

Inside contacts: Interaction with facility departmental staff, including Dep’t Managers, Physicians, Medical Secretaries, Schedulers and Patient Accounting Reps.

MAJOR CHALLENGES

Providing quality service to internal and external customers in a demanding environment by prioritizing incoming workload and assisting patients.

DECISION MAKING RESPONSIBILITIES

Evaluating patient information relative to adequacy and how to correct inaccurate data or obtain missing data. Make certain of the proper routing of patients based on scheduled services and coordination of patient flow.

Analyze patient financial responsibility for referral to Financial Counselor.

Qualifications

Required:

• High School Diploma or GED
• Complies with regulatory requirements (i.e. TJC) appropriate for position.
• Possess excellent customer service skills in pressure situations
• Possess excellent communication skills
• 1-2 years of recent experience in patient registration or equivalent in a hospital setting
• Experience and understanding of insurance plans and benefits and the verification process
• Ability to work in a team environment
• Thorough knowledge of each Physicians/Departments unique registration requirements
• Good PC skills as they relate to registration/patient accounting systems, email and other Microsoft applications. Experience with SMS desirable
• Ability to prioritize and manage individual assignments for the overall improvement of the registration process
• Knowledge of financial counseling process and ability to provide services to support the financial counselor. Services include assisting patients in understanding their insurance plan along with their financial responsibility as it relates to deductibles, co-payments, coinsurances, out-of-network benefits and any non-covered services. Collect deposits and payments from patients for the scheduled services.

Pay range: $19.50 - $28.62 hourly

Individual wages are determined based upon a number of factors including, but not limited to, an individual’s qualifications and experience

Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.