Patient Access Representative

Job Details:
Level: Experienced,

Job Location:

Dilkon Medical Center - Dilkon, AZ 86047, Position Type:
Full-Time, Education Level: High School Diploma, Travel Percentage:
Occasionally, Job Shift: Any, Under general supervision of the Patient Access Supervisor with indirect supervision by the Deputy Quality Officer, the Patient Access Representative collects and coordinates the use of key demographic information; utilizes the information to manage alternate resource coordination, Purchased Referred Care requests and eligibility services. Uphold the principles of WIHCC’s Vision, Mission, and Value Statements. Maintains confidentiality of all privileged information at all times.

This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all-inclusive.

• Maintains regular attendance and punctuality.
• Serves as first point of contact as a representative of WIHCC.
• Interviews patients to obtain pertinent patient registration information; i.e., demographic and insurance information as well as a signature of authorization to enable Winslow Indian Health Center to bill for health care services provided from all alternate resources, including the non-beneficiary services.
• Determines the eligibility of patients in accordance with Indian Health Services and Navajo Area Contract Health Services/Purchased Referred Care guidelines.
• Collects third party recipient health cards, obtains photocopies of the card and explains the program to the beneficiaries, i.e., why Medicare, Medicaid and/or private/commercial insurance, will be billed for the services they received at the WIHCC, Inc. facility.
• Utilizing the RPMS Patient Registration Modules, manages, key-enters, updates and verifies all alternate resource data necessary for patient registration and for accurate billing through the use of the RPMS and electronic health record system.
• Maintains communication with HIM Dept., Nursing, Medical Staff, Purchased Referred Care, Patient Benefits Coordinators, and the Revenue Cycle.
• Determines the eligibility of patients seeking health care, who have not previously been treated at the facility, by obtaining the Certificate of Indian Blood or other documentary proof of tribal affiliation.
• Receives and screens incoming calls for the Outpatient Clinics directing them to their proper destinations, handles requests for routine information personally, and refers all non-routine requests to the proper staff person.
• Assists providers with Navajo interpretation for patients upon request.
• Makes appointments for patients referred from clinics for follow-up appointments or new visit appointments, consults or specialist.
• Obtains signatures and assists patients in completing new or updated forms required for Patient Registration such as Workers Comp, Motor Vehicle Accident Form, Medicare Secondary Payer Questionnaire Form, and alternate resources.
• Verifies AHCCCS and Medicare daily.
• Provides appropriate scheduling for their designated clinic and provides detailed information concerning eligibility for and availability of specific clinical services.
• Maintains strict guidelines when scheduling for all medical and specialty clinics.
• Assist with clerical duties such as scanning, faxing and copying documents, etc.
• Maintains a well-organized and clean environment to work at maximum efficiency and prevent transmission of infection and disease.
• Requires completion of tasks or duties assigned by a supervisor.
• Uphold all principles of confidentiality and patient care to the fullest extent.
• Adheres to all professional and ethical behavior standards of the healthcare industry.
• Adheres to WIHCCs Personnel Policies and Procedures, departmental policies, rules, and regulations.
• Interacts in an honest, trustworthy and dependable manner with patients, employees, visitors, and vendors.
• Possesses cultural awareness and sensitivity.
• Maintains compliance with all Human Resources requirements.
• Performs other duties as assigned.

High School Diploma or GED required. One to two years clerical or customer service related experience and/or training. Administrative experience in a health care setting preferred. Basic medical terminology, and Computer proficiency. CPR Certification within three months of hire. Bilingual skills in English and Navajo language highly recommended. Must maintain a valid unrestricted and insurable driver’s license. Must successfully pass a background…