Patient Access Services Representative - TMCOne - Vail Cardiology Job at Tucson Medical Center (Tucson)

Job Description

Patient Access Services Representative - TMCOne - Vail Cardiology. Job Category: Clerical. Schedule: Full time. Shift: 1 - Day Shift. SUMMARY: Assists medical care givers with patient management, tracking and monitoring requirements. Answers phones, pre-screens using appropriate triage skills, within allowable parameters calls in prescription re-fills, calls patients with test results and schedules patients for next appointments. Perform extensive centralized scheduling, insurance verification, referral, billing and payment posting responsibilities.

Job Responsibility

Assists medical care givers with patient management, tracking and monitoring requirements
Answers phones, pre-screens using appropriate triage skills, within allowable parameters calls in prescription re-fills, calls patients with test results and schedules patients for next appointments
Perform extensive centralized scheduling, insurance verification, referral, billing and payment posting responsibilities
Exhibits excellence in customer service through appropriate attitude and interaction with all patients, visitors and staff
Adheres to and supports team members in exhibiting TMCH values of integrity, community, compassion, and dedication
Collects deposits or deductibles and advises patient or guarantor of insurance benefits and anticipated cost estimates
Ensures that cash handling follows corporate policies
Ensures completion of financial documentation in accordance with TMCH's credit and collection policies
Explains all necessary compliance forms and obtains patient signature as required for regulatory agencies
Performs medical necessity screening and ensures compliance with system requirements
Interacts with physicians and/or physicians' office staff to secure diagnosis, procedure details or authorizations and information for denials as needed
Uses medical terminology and scheduling knowledge to select correct procedure when scheduling and coordinates information with other departments as needed
Demonstrates knowledge of resources, staffing, instrumentation, and equipment specific to procedures to avoid scheduling conflicts
Performs patient registration activities to ensure accurate financial and biographical data and documentation have been obtained and properly entered into hospital records
Completes insurance processing
including account creation, insurance verification, notification, and authorization functions, follow ups on denials and no response claims
Communicates with departments/physicians for special requests, emergent cases, overbooking and add-ons
Informs management about issues/problems with tools/times
Handles incoming telephone calls and exercises judgment in scheduling caller for correct procedure in appropriate service area
Receives telephone requests to schedule from patients, physicians, physician office staff, employers, and hospital personnel, if applicable
Explains procedure preparations to patients so they are properly prepared before arriving at the hospital or clinics as needed
Documents all notification, authorization and eligibility information in the registration systems, uses electronic verification tools and web-based resources
Analyzes patient accounts, determines non-collectable accounts, and recommends bad debt or charity write-offs when applicable
Analyzes and processes contractual write-offs
Arranges payment methods or extensions of credit with patients or representatives
Evaluates accounts and determines payment dates based on patient's ability to pay and hospital policies
Explains charges, services, and hospital policy regarding payment of bills
Arranges account collections and contacts carriers to follow-up on balances due
Maintains current working knowledge of payer regulations, contractual agreements, computer updates, and new collection tools including understanding of the Fair Debt Collection Practice Act
Provides information about external financial assistance, including recommending third parties
May serve as a Medical Assistant when holds a Medical Assistant Certification
Processes Accounts Payable transactions such as: checks and posts payments to accounts receivable and verifies account balances
Prepares, reconciles, balances, and batches daily deposits and prepares receipts for deposits
Verifies totals on reports and forms as required
Reviews accounts with unusual balances after posting payments and adjustments
Researches and transfers monies between logs, as needed
Adheres to TMCH organizational and department-specific safety, confidentiality, values policies and standards
Performs related duties as assigned.

Requirements

High School diploma or General Education Degree (GED), completion of vocational medical office training desired, or an equivalent combination of relevant education and experience
Preferred one (1) year of medical office and/or hospital experience to include healthcare eligibility and benefit analysis or scheduling experience for diagnostic testing and/or surgery
Some positions may require certification as a Medical Assistant (CMA).

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Patient Access Services Representative - TMCOne - Vail Cardiology

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