Patient Access Representative III

Organization:MPHS-Mills-Peninsula Medical CenterPosition Overview:Obtains all necessary information to register and financially clear patients. Acts as a key resource by providing functional guidance and direction to new employees, resolving problems, using sound judgment and initiative as workflow requires. Helps foster an environment in which continuous improvement in business processes and services is welcomed and recognized. Responsible for providing issue identification, assessment, and resolution as well as technical support in order to achieve desired outcomes and compliance with the Electronic Health Record (EHR) and Sutter Health policies and standard procedures. Oversee the collection of information that is obtained during the registration work flow process to ensure efficient and accurate registration of patients in Emergency, Ambulatory, Inpatient and Outpatient service areas related to hospital billing and compliance.Job Description :These Principal Accountabilities, Requirements and Qualifications are not exhaustive, but are merely the most descriptive of the current job. Management reserves the right to revise the job description or require that other tasks be performed when the circumstances of the job change (for example, emergencies, staff changes, workload, or technical development).JOB ACCOUNTABILITIES:ASSIGNMENT SPECIFIC RESPONSIBILITIES: Greets patients/family members and obtains and/or verifies demographic, clinical, financial, and insurance information in the process of financially clearing patients for service delivery, including the entry of patient/guarantor information in the patient registration/accounting systems, collection of patient signatures on all appropriate forms and the imaging/copying of registration documents. Utilizes inputs to authenticate and register patients for service delivery for patients who have registered through the Patient Access Center; for those who are not registered, completes the end-to-end process of registration through close-out for service delivery. Obtains and processes signed physician orders. Maintains assigned work queues. Conducts insurance eligibility/benefit verification, referral/authorization, and financial education on designated accounts. Calculates estimated patient liability, informs patient/guarantor and actively collects appropriate patient liabilities, including co-payments, deductibles, and deposits at time of service and/or processes patient payments, accepts payments on prior services. Refers appropriate cases to financial counseling for follow-up and consultation. Executes other duties as assigned, such as cashiering, bed management, and communications operator. Enhances the patient experience throughout all patient interactions, which will be face-to-face or by other means of communication demonstrating knowledge of Sutter’s Health system and service offerings.CONTINIOUS IMPROVEMENT: Supports the implementation of programs, policies, initiatives, and tools specific to the Shared Services. Organizational process owned by Patient Access across the Shared Services Organization. Contributes ideas and actions towards the continuous improvement of Patient Access related processes within area of influence.PEOPLE DEVELOPMENT: Adaptable to learning new processes, concepts, and skills Seeks and responds to regular performance feedback from team lead; provides upward feedback as needed.RELATIONSHIP MANAGEMENT: Maintains positive work relationships with members of other teams in the Shared Services Organization to communicate effectively and to ensure compliance with cross-team responsibilities. Assists in ensuring efforts of the Patient Access Client Location Team support building strong peer-to-peer relationships.PATIENT SATISFACTION: Performs revenue cycle tasks necessary to ensure compliance and exceptional customer service. Authenticates patient identity throughout all processes. May provide directional support to patients and/or family members. Maintains knowledge of applicable Federal, State, and local laws and regulations, Standards of Conduct, Standards of Behavior, as well as Sutter policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior. Meet the department monthly cash goal.ELECTRONIC HEALTH RECORD (EHR) SUPPORT: Performs EHR workqueues reviews and provides ongoing Admission, Discharge, Transfer (ADT resolution as well as technical support in order to achieve desired outcomes and compliance with the EHR and Sutter Health policies and standard procedures. Responsible for clearing ADT hospital billing work queues. Identify and edit errors that are preventing charges to be billed to insurance companies for reimbursement. Responsible for the release and corrections of workeque errors ensuring an efficient and timely reimbursement to the organization. Works closely with Patient Access and Clinical department leadership and communicate with all appropriate parties to ensure accounts are resolved and properly billed. Correct and log any registrations errors and provide appropriate notification to Patient Access Management when error rate exceeds the set standard allowed. Provide error feedback and education to all Patient Access staff. Responsible for creating work flow process tip sheets to improvement registration and revenue processes to Patient Access staff, as needed. Create and track system work flow service help tickets for EHR improvements, implementations and troubleshooting for patient chart corrections. Establish and maintain a collaborative relationship with appropriate Sutter affiliates to identify and explore possible resolutions of help tickets.EDUCATION:Equivalent experience will be accepted in lieu of the required degree or diploma.HS Diploma or equivalent education/experienceTYPICAL EXPERIENCE:2 years of recent relevant experience.SKILLS AND KNOWLEDGE:General knowledge of patient access, financial counseling, functions in acute, and non-acute settings.Working knowledge and understanding of insurance and medical terminology.Emergency Medical Treatment and Active Labor Act (EMTALA) and Consent Laws knowledge.Time management skills and the ability to manage frequent in-person patient contacts while effective maintaining and documenting data in the patient registration systems.Demonstrated ability to work in multiple computer systems, such as patient registration/accounting systems, telephone consoles, document imaging, scanning, payment posting, proprietary payer websites and data quality monitoring, both accurately and efficiently.Possess verbal and written communication and active listening skills.Accuracy and attentiveness to detail required.Decision making and problem solving skills.Must be able to work concurrently on a variety of tasks/projects in diverse environment.Ability to meet or exceed targeted customer service, productivity and quality standards.Computer proficiency skills required.Requires the ability to work with and maintain confidential information.PHYSICAL ACTIVITIES AND REQUIREMENTS:See required physical demands, mental components, visual activities & working conditions at the following link: Job Requirements (https://sutterhealth.sharepoint.com/:b:/s/JobAnalysisLibrary/ERB-IcsfFyhBhpp4HJcgNqEBFRddckIt9zQxcajIATM7iA?e=xcUfQf)Job Shift:DaysSchedule:Full TimeShift Hours:8Days of the Week:Monday - FridayWeekend Requirements:NoneBenefits:YesUnions:NoPosition Status:Non-ExemptWeekly Hours:40Employee Status:RegularNumber of Openings:1Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.Pay Range is $33.33 to $41.66 / hourThe salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.