Patient Access Services Representative Job at Tucson Medical Center (Tucson)

Job Description

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
collects deposits or deductibles and advises patient or guarantor of insurance benefits and anticipated cost estimates
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)
knowledge of office management practices, including billing and scheduling within healthcare
knowledge of basic computer familiarity and experience and the ability to operate basic office equipment
knowledge of patient care protocols and practices
knowledge of general patient care practice, methods and regulations
skill in evaluating patient’s needs or following up with a care-giver and then providing follow up support to patients
skill in scheduling appointments and referrals
ability to read or listen and comprehend simple instructions, short correspondence, and memos
ability to write simple correspondence
ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization
ability to read and interpret documents such as safety rules, procedure manuals, and governmental regulations
ability to effectively present information and respond to inquiries or complaints from patients and/or their representatives and the general public
ability to interpret and explain insurance benefits and patient financial responsibility
ability to provide excellent customer service via phone and walk-ins
ability to apply common sense understanding to carry out simple/detailed written or oral instructions
applicants must have basic computer familiarity and experience and the ability to operate basic office equipment

Nice to have

completion of vocational medical office training
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
certification as a Medical Assistant (CMA)

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Patient Access Services Representative

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Patient Access Services Representative

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Patient Access Services Representative

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