Patient Access Representative - Santa Monica

University of California - Los Angeles Health; Santa Monica (CA); On-site; USD 86,334,000 - 113,900,000; Full time

Job summary

University of California - Los Angeles Health is seeking a Patient Access Representative to pre-register, pre-admit, and admit patients by phone or in person. You will gather accurate demographic and insurance details, obtain prior authorizations, and coordinate with public programs such as Medi-Cal and CCS to optimize benefits.

The role involves working with physicians and hospital staff to implement Medicare requirements and ensure timely reimbursement, while guiding patients to discharge or

Qualifications

• Knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi‑Cal, CCS programs, out-of-state Medicaid, or other sponsoring agencies
• Knowledge in the functional operations of third party payers and utilization review agencies to expeditiously coordinate follow-up
• Working knowledge of third party payer verification terminology
• Working knowledge of medical terminology to identify procedures for optimal benefit information
• Ability to accurately and completely process payments and cash receipts
• Ability to write concise, grammatically correct reports and correspondence

Responsibilities

• Pre-registers, pre-admits, and admits patients by telephone and/or in person
• Collects accurate demographic information and reviews benefits
• Obtain prior authorizations and assist with cash collections
• Interact with physicians and hospital personnel to implement Medicare requirements
• Refer appropriate cases to internal/external sources for discharge/post-hospital care
• Collaborate with Utilization Review and Patient Business Services to ensure proper reimbursement

Skills

Medicare knowledge

Medi-Cal knowledge

Payer verification

Medical terminology

Cash handling

Job description

Description

As the Patient Access Representative, you will be responsible for:

• Pre-registers, pre-admits, and admits patients by telephone and/or in person
• Collection of accurate demographic information, review and interpretation of insurance benefits
• Obtaining prior authorizations, cash collections, interaction with public assistance programs (i.e. Medi-Cal, CCS)
• Implementation of Medicare requirements, interaction with physicians/office personnel as well as other hospital personnel (i.e., SDA, OPSU, nursing units)
• Referral of appropriate cases to other internal and external sources to assist patients with discharge/post-hospital care
• Interacting with hospital departments such as Utilization Review and Patient Business Services to ensure correct and timely reimbursement

Salary Range: $30.13/hour - $39.75/hour

Qualifications

We're seeking an exceptional, self-directed professional with:

• * Knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS programs, out-of-state Medicaid, or other sponsoring agencies
• * Knowledge in the functional operations of third party payers and utilization review agencies to expeditiously coordinate follow-up
• * Working knowledge of third party payer verification terminology
• * Working knowledge of medical terminology to sufficiently identify various procedures to obtain optimum benefit information and
• * Ability to accurately and completely process payments and cash receipts
• * Ability to write concise, grammatically correct reports and correspondence