Patient Access BH 1

Ketchikan Indian Corporation; Ketchikan (AK); On-site; USD 35,000 - 48,000; Full time

Job summary

Ketchikan Indian Corporation is seeking a Patient Access Representative (PAR) to be the first behavioral health contact, coordinating care between patients and department staff. You will schedule appointments, verify insurance, enroll patients in the information portal, and complete reminder calls before visits.

The PAR also assists with coverage, provides excellent customer service, and ensures HIPAA compliance while handling sensitive information and guiding patients through the clinic process.

Qualifications

• High school diploma or GED required.
• Two years of customer service, registration processing, medical office, or computer database experience preferred.

Responsibilities

• Pre-registers and registers patients with accurate demographic and financial data.
• Verifies coverage and assists with prior authorization as appropriate.
• Schedules appointments, makes reminder calls, and coordinates referrals.
• Greets patients and assists with directions and lobby observation.
• Maintains HIPAA compliance and protects patient information.
• Handles patient interactions professionally and resolves issues.
• Performs other duties as assigned.

Skills

Customer service

Registration processing

Medical terminology

Insurance processes

HIPAA compliance

CPT/ICD coding

Oral and written communication

Problem solving

Education

High school diploma or GED

Tools

CPT/ICD coding

Job description

Job Summary

The Patient Access Representative (PAR) is the first Behavioral Health services impression to provide patient interaction at the beginning and end of each visit. Incumbent will assist in care coordination between the patient and department staff by scheduling patients, verifying insurance/eligibility, enrolling patients in the information portal, completing reminder calls, and assisting in obtaining important information concerning the transmission of disease prior to arrival in the clinic.

Assists with department coverage as needed and performs other duties as assigned.

Essential Job Functions

• The PAR works directly with the patient assisting, updating, and utilizing alternate resources.
• Completes pre-registers / registers patient with accurate patient demographic and financial data. Upon registration, address co‑insurance for scheduled appointment/procedure, etc.
• Verifies coverage and ensures all insurance requirements are met, as well as assistance with prior authorization as appropriate prior to patient arrival.
• Manages daily appointment schedules which may include reminder calls and calling all referrals. May transport patients utilizing escort or wheeled transport equipment.
• Greets patients and visitors, in person or on the telephone.
• Provides directional assistance for those accessing the clinic and observes patients waiting in the lobby for any distress signs.
• Connects telephone calls to requested individual in a rapid, accurate, and professional manner.
• Answers or refers inquiries to the appropriate department or individual.
• Effectively manages conflict in an understanding and professional manner, approaching all tasks with excellence in customer service and good interpersonal skills.
• Adheres to safety procedure; remains vigilant and informs security of any unusual activity.
• Completes safety modules and performs duties as delegated during an emergency.
• Ensures HIPAA compliance.

Knowledge, Skills, and Abilities Requirements

• Knowledge of customer service concepts and practice.
• Knowledge of basic medical terminology and clinic systems.
• Knowledge of insurance processes and regulations.
• Knowledge of CPT/ICD coding (preferred).
• Knowledge and ability to carry out rules of Health Insurance Portability and Accountability Act (HIPAA), which protects patient rights.
• Skill in operating a personal computer utilizing a variety of software applications.
• Skill in oral and written communication.
• Skill in establishing and maintaining cooperative working relationships with other employees.
• Skill in reviewing, researching, processing, and troubleshooting difficult matters.
• Ability to exercise mature judgment in evaluating specific situations and recommending solutions.

Physical Activities Include

• Must be able to hear. Specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
• Ability to use hands to finger, handle or operate objects, tools, or controls; reach with hands and arms; climb or balance; stoop, kneel, crouch; and taste or smell.
• Activities require standing, sitting, walking, bending, and stooping, climbing on stools and ladders, and routinely lifting and carrying items and boxes up to ten (10) pounds.
• Writing by hand and using a personal computer.
• Long hours in front of computer screen.
• Traveling occasionally to out-of-town meetings and functions.

Working Conditions

Work is performed in a small office with limited storage, filing and workspace. People asking questions/directions frequently interrupt incumbent. Some work is performed in conference rooms and at photocopy/fax machine.

Working Environment

The environment involves the usual risks and stress of an office environment within an ambulatory health care facility. The employee may be exposed to communicable diseases. Safety precautions for employees such as blood drawing for screening of various diseases such as hepatitis, required immunizations, etc. are necessary. The employee is occasionally subject to verbal abuse, threats, and physical violence from angry, hostile, or disgruntled patients and/or family members.

KIC Competencies

• Cultural Competency: To be respectful and responsive to the health beliefs, practices, and cultural and linguistic needs of KIC Tribal Members. Developing cultural competence is an evolving, dynamic process that takes time and occurs along a continuum.
• Commitment: To serve Tribal Members and set a high standard for yourself in your performance; strive for results and success; convey a sense of urgency and bring issues to closure; and stay persistent despite obstacles and opposition.
• Customer Service: Meet/exceed the expectations and requirements of internal and external customers; identify, understand, and monitor the needs of both internal and external customers, always talk and act with customers in mind; and recognize working colleagues as customers.
• Effective Communication: Ensure important information is passed to those who need to know; convey necessary information with respect, clearly and effectively orally or in writing.
• Responsiveness and Accountability: Demonstrate a high level of conscientiousness; hold oneself personally responsible for one's own work; and do the required fair share of work.

Qualifications

Education: High school diploma or GED required.

Experience: Two (2) years customer service, registration processing, medical office or computer database experience preferred.

License: Possess current valid State of Alaska driver's license with a record acceptable to KIC’s Insurance carrier.

Progressive responsible administrative/management work that indicates ability to acquire the particular knowledge and skills needed to perform duties of this position.