Patient Access Rep IV FT, Dayshift

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Pay Range:

$20.10 - $26.13

Scheduled Weekly Hours:

40

Position Overview

SUMMARY (Basic Purpose of the Job):

Functions as subject matter expert to ensure department compliance with system and operational changes and assists in training to support ongoing staff education and development. Able to perform all registration functions independently. Registers patients accurately, efficiently, and professionally to ensure database integrity and facilitate claims processing. Applies financial screening guidelines to ensure collectable accounts. Utilizes standards, guidelines, and written procedures for performing registration functions. Communicates effectively and works cooperatively with others. Utilizes standards, guidelines, and written procedures for performing registration functions.

MINIMUM REQUIREMENTS:

Education: High school diploma or equivalency.

Experience: Two-year patient access experience. Knowledge of all Capital Health departments required.

Knowledge and Skills: Excellent verbal and written skills. Strong customer service and problem-solving skills.

Special Training: Proficient computer skills. Advanced health insurance and prior authorizations knowledge.

Mental, Behavioral and Emotional Abilities: Possesses ability to work independently and as a team member.

Usual Work Day:8 Hours  

ESSENTIAL FUNCTIONS:

• Assists in training, problem solving, and chart review with subordinate patient access representatives. Assigns duties to registrars as directed by Supervisor or Manager.
• Demonstrates ability to independently manage all assigned responsibilities. Able to troubleshoot any department issues.
• Expert in all Patient Access department needs. Provides coverage in working areas as required when on-call duties apply.
• Advanced in registering patients quickly and accurately, exceeding productive levels of a Patient Access Rep III.
• Acts as a liaison for physician offices and ancillary departments as needed.
• Serves as a resource for Patient Access department. Leads department through daily workload and divides work as needed.
• Follows compliance with computer system procedures, department procedures, and training guidelines to accurately complete each registration.
• Reviews charts for accurate demographics, Medicare compliance, proper CPT codes, authorizations and referrals, necessary signatures, and completion of all forms.
• Performs follow up with physician office, central scheduling and insurance companies to obtain any required authorization, referrals or to obtain update physician orders
• Complies with department procedures and regulatory guidelines for Medicare Secondary Payer, Medicare Medical Necessity, Advance Beneficiary Notice, Advance Directives, Patients’ Rights, and the Interpreter flag as measured by review and observation.
• Follows and monitors staff compliance with following payer requirements for authorization, pre-authorization, referrals, coordination of benefits, and in-network verification according to Insurance Database, and Insurance Verification guidelines.
• Follows Self Pay procedure regarding No Surprise Billing Act and referrals to Medicaid and charity.
• Assists with departmental training and education of patient access staff.
• Communicates effectively with Patient Access team members and is open to feedback and suggestions in order to identify opportunities for improvement
• Identifies and seeks out members of the registration department as a resource to increase knowledge and seek validation of department guidelines and procedures.
• Reports to Management Team regarding department deficiencies to include faulty equipment, supplies and concerns.
• Supports department performance improvement initiatives. Communicates ideas to meet department goals.
• Attends all mandatory department meetings. Follows patient identification policy.
• Performs other duties as needed.

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

Frequent physical demands include: Sitting , Wrist position deviation , Pinching/fine motor activities

Occasional physical demands include: Standing , Walking , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Keyboard use/repetitive motion

Continuous physical demands include: Talk or Hear

Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.

Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Depth Perception, Accurate HearingAnticipated Occupational Exposure Risks Include the following: Bloodborne Pathogens , Airborne Communicable Disease , Extreme Noise Levels , Dust/Particulate Matter

This position is eligible for the following benefits:

• Medical Plan

• Prescription drug coverage & In-House Employee Pharmacy

• Dental Plan

• Vision Plan

• Flexible Spending Account (FSA)

- Healthcare FSA

- Dependent Care FSA

• Retirement Savings and Investment Plan

• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance

• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance

• Disability Benefits – Long Term Disability (LTD)

• Disability Benefits – Short Term Disability (STD)

• Employee Assistance Program

• Commuter Transit

• Commuter Parking

• Supplemental Life Insurance

- Voluntary Life Spouse

- Voluntary Life Employee

- Voluntary Life Child

• Voluntary Legal Services

• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance

• Voluntary Identity Theft Insurance

• Voluntary Pet Insurance

• Paid Time-Off Program

The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level. 

The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.