Patient Access Representative II - Remote

Patient Access Representative II - Remote - 1122

HI:

Big Island:

Kealakekua:

KONA COMMUNITY HOSPITAL or Remote | Clerical, Administrative and Support | Permanent/Full-time

Posted a week ago

POSITION STATUS : 1.00 | Permanent

SALARY RANGE :BU03 | SR13

SALARY RATE: $46,800 to $54,756 (Annual Salary) based on the Full Time Employment

SHORTAGE DIFFERENTIAL
: $692/month

JOB DUTIES :

A. INSURANCE VERIFICATION

1. Reviews patient demographic information collected through the preadmission, admission, or registration process for accuracy.

2. Contacts insurance carriers to obtain benefits and eligibility for the specific insurance plans.

3. Utilizes electronic media for validating insurance plan codes, certificate numbers and expirations of coverage.

4. Validates the certificate numbers for each insurer/subscriber.

5. Enters the subscriber verification information in the IBAX hospital patient data base system.

6. Updates patient record with specific changes required prior to bill production.

7. Conducts precertification when necessary in order to ensure coverage for services.

8. Refers continued stay certification to the Utilization Review Coordinator when information is needed beyond what the Patient Access Department can provide.

9. Addresses error resolution with the appropriate Patient Access staff for improved future results.

B. PREADMISSION/ADMISSION OF PATIENTS:

1. Interviews patients or their representatives and obtains demographic and primary and secondary insurance information.

2. Researches and update previous records within the information system OR enters information to create a new file.

3. Notifies appropriate hospital personnel of new registrations so that admitting orders can be obtained.

4. Explains hospital policies regarding room accommodations and visitors.

5. Discuss and determine method of payment with the patient and/or responsible party, collects deposits, and acquires signatures on all pertinent forms.

6. Initiates and accurately completes all necessary admitting forms recognizing that these documents constitute a medicolegal document.

7. Prepares an addressograph plate showing pertinent patient information by utilizing an electric plastic plate embosser.

8. Prepares a patient wristband and attaches the wristband to the patient.

9. Assigns the patient a bed taking into consideration the needs of the patient, special orders written by the admitting physician, and unit availability.

10. Directs the patient to the assigned nursing unit and forwards all pertinent documents with the patient or escorts patients in need of assistance.

11. Inputs additional information into the system as directed.

12. Complies with rules, regulations, rights and statutes of State, Federal, hospital and hospital regulatory agencies.

13. Calculate, obtain and process advance cash and credit deposits.

14. Works closely with billing department to resolve all billing/collections issues.

C. SWITCHBOARD COVERAGE/CENTRAL COMMUNICATIONS

1. Answers and refers incoming calls to the proper department of person.

2. Maintains a record of all toll calls and places emergency calls for the medical staff or nursing. Main information clerk for entire hospital and/or receptionist for Patient Access.

3. Makes special announcements over the PA system/Radio and pages the medical staff and hospital personnel as needed.

4. Announces fires, disasters, or drills to all hospital personnel over the PA system.

5. Refers to disaster procedures and promptly notifies key hospital personnel of an anticipated/actual disaster.

6. Participates in County Civil Defense exercises and dry-runs.

7. Refers employee sick calls to the respective department head.

8. Assists in the notification of on-call personnel.

9. Maintains a daily sign in/out sheet of on call personnel that are on property.

10. Monitors emergency systems (fire, nitrogen, oxygen, lifeline) and serves as communications control.

D. OTHER UNIT RESPONSIBILITIES:

1. Distributes the precensus and census daily for update by nursing personnel.

2. Updates the hospital patient data base system to reflect transfers, bed swaps, and discharges at the direction of the nursing units.

3. Computes and maintains admitting and census statistics as required for various agencies such as the Department of Human Services and Medicare and for hospital administration on a monthly basis.

4. Distributes copies of admission summaries to departments and physicians.

5. Assists in the training of new employees on all functions

6. Administers, monitors and audits hospital…