Patient Access Representative I - Scheduling

West Tennessee Healthcare; Jackson (MS); On-site; USD 38,000 - 54,000; Full time

Job summary

West Tennessee Healthcare in Jackson, TN, seeks a PAS Representative to complete financial clearance in Patient Access Services. You will create a positive first impression for patients and families and ensure understanding of financial responsibilities.

You will interview patients, collect information for pre-registration and registration, verify insurance benefits, determine eligibility, coordinate referrals, and obtain necessary authorizations.

Qualifications

• High school diploma or equivalent.
• 1-2 years of health care or related experience preferred.
• Ability to interview patients and collect information for financial clearance.
• Excellent communication and customer service skills.

Responsibilities

• Process financial clearance and maintain department guidelines.
• Manage daily work queues and correspondence.
• Perform pre-registration and registration of patients.
• Verify insurance payer plans and billing addresses in the system.
• Inform families about financial assistance options.
• Conduct initial financial screening and refer to financial counseling.
• Obtain referrals and treatment authorizations as required.
• Communicate with staff and external payers to coordinate care.
• Maintain accurate files for pre-processing information.
• Investigate and resolve patient problems promptly.

Skills

Communication

Interpersonal skills

Attention to detail

Education

High School Diploma

Job description

Category:

Admin Support

City:

Jackson

State:

Tennessee

Shift:

10 - Day (United States of America)

Job Description Summary:

This position is responsible for completing the financial clearance process within Patient Access Services and creating the first impression of WTH’s services to patients and families and other external customers. The PAS Representative must be able to articulate information in a manner that patients, guarantors, and family members understand so they know what to expect and have an understanding of their financial responsibilities. This position assumes responsibility for collecting and documenting information on behalf of the patient. The PAS Representative may be responsible for completing the pre-registration, registration, insurance verification, benefits verification, certification, referral management, patient liability collections, and medical necessity check – as well as interviewing patients and guarantors to obtain information to screen for financial counseling, verifying eligibility and corresponding benefit levels, coordinating referrals, and obtaining treatment authorizations. The PAS representative will also work with medical staff, nursing, ancillary departments, insurance payers, and other external sources to assist families in obtaining healthcare and financial service

ESSENTIAL JOB FUNCTIONS:

• Process - Maintains the best practice routine per department guidelines.
• Daily work queues are maintained at acceptable levels according to department policies.
• Correspondence worked daily to current.
• Registration - Performs financial clearance process by interviewing patients and collecting and recording all necessary information for pre-registration and registration of patients.
• Ensures that proper insurance payer plan choice and billing address are assigned in the automated patient accounting system.
• Verifies relevant group/ID numbers.
• Completes the registration process according to established policies and procedures.
• Informs families with inadequate insurance coverage regarding financial assistance through government and financial assistance programs.
• Performs initial financial screening and refers accounts for financial counseling and/or appropriate eligibility assessments.
• Ensures all referrals and treatment authorizations for all patient types have been obtained according to the outlined requirements.
• If not obtained, contact payers for approvals.
• Completes initial medical necessity checks.
• Refers to the designated area if medical necessity fails or if referrals /authorizations are denied.
• Communication & Miscellaneous - Advises next-level leader of possible postponement or deferrals of any elective/non-emergent admission which has not been approved prior to service date.
• Maintains accurate files for pre-processing information as required.
• Investigates, resolves, and documents patient problems in a timely and efficient manner.
• Maintains accurate files for pre-processing information.

JOB SPECIFICATIONS:

EDUCATION:

• High School Graduate, or equivalent

LICENSURE, REGISTRATION, CERTIFICATION:

• N/A

EXPERIENCE:

• 1-2 years of health care or related experience preferred.

NONDISCRIMINATION NOTICE STATEMENT

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, disability, religion, national origin, gender, gender identity, gender expression, marital status, sexual orientation, age, protected veteran status, or any other characteristic protected by law.