The Patient Access Service Representataive would accurately and expeditiously conducts interviews with patients, families, or other members of the public in a tactful but assertive manner during the admission process. Compiles, verifies, analyzes, and distributes demographic, insurance, and financial information to be used by various hospital departments, the billing office, insurance carriers, and a range of local, state and federal agencies to assure proper compliance and prompt service to patients. Initiates and coordinates referrals for financial assistance programs. Assures verified data will provide accurate billing of charges and timely collection of accounts. Supports hospital and departmental goals in a manner that will enhance the successful operation of the hospital and create a positive image to the public.
SUPERVISORY ACCOUNTABILITY: None
NATURE AND SCOPE:
Interacts with patients and family members. Physicians, physician's offices, clinics, county health departments, nursing facilities, other type of referral providers, staff in within other departments as well as the business office. Interacts with state and federal agencies and insurance providers.
Supports the mission, vision and values of the hospital.
Responsible for working in a safe and protective manner at all times, keeping in mind that safety and environmental hazards are the responsibility of all employees for themselves, other staff members and patients.
Gather information necessary to complete the registration of patient, through telephone, computer, and/or face-to-face interviews with the patient and/or family members and verifies accuracy.
Obtains required signatures for consent to treatment, assignment of benefits, release of information, confirmation of information provided, statements of income/third-party coverage, living will/healthcare proxy and other federal, state and county forms required.
Collects amounts owed and issues receipts.
Prepares payments collected for delivery and deposit. Reconciles cash drawer daily.
Interviews patients with the intent of collecting or securing acceptable financial arrangements, from patients with/without insurance or whose insurance will not cover hospitable charges in full and establishes reasonable payment plans based upon consistent patient financial services policies and the patient's ability to pay.
Acts in a consultative role to patients regarding payor information and resources available for account balances. Works collaboratively inter and intra-departmentally to achieve goal of accurate, timely registration information and related payment of balance.
Consistently achieves 100% accuracy and completeness of data collection and input.
Participates in peer audits to ensure accuracy and quality of data. Follows department procedures to report results of audits.
Obtains and accurately completes Medicare Secondary Payor (MSP) ABN forms, when applicable.
Reviews accounts for accurate registration information, verifying insurance information, obtaining necessary benefits and per-certification. Refers accounts to case management to obtain clinical information for insurance certification.
Notifies nursing services and arranges escort of patient to room (inpatient) and directs patient to appropriate ancillary department (outpatient).
Accurate scanning of medical records into HPF medical record system, including assembling of charts for clinical staff.
Performs other duties as assigned.
Able to maintain confidentiality of all scheduling, registration and admission information.
Self-directed with multi-tasking skills to work in a fast-paced environment.
Must manage a high volume of deadlines and deliverables. Ability to establish and maintain effective relationships with physicians, patients and staff.
Ability to deal effectively with persons of varying backgrounds and personalities.
Demonstrates strong analytical, critical thinking, and problem-solving skills.
Exceptional interpersonal and communication skills.
Ability to meet deadlines and productivity targets.
Maintains performance rating of behaviors/CCIRH values at "3" or above using a scale of 1-5.
AA Degree in business, healthcare or related field required; may substitute minimum of two (2) years' external experience in lieu of AA Degree.
Able to communicate effectively in English, both written and orally; additional languages are preferred.
Collection experience preferred.
Working knowledge of ICD-10, CPT and HIPPA regulations.
PC proficiency with MS Office products to include Word and Outlook.
CCIRH IS A DRUG AND NICOTINE FREE WORKPLACE
The policy of Cleveland Clinic and its system hospitals (Cleveland Clinic) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic's Smoking Policy will be permitted to reapply for open positions after 90 days. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic facility.
Cleveland Clinic is pleased to be an equal employment employer: Women/Minorities/Veterans/Individuals with Disabilities