Patient Access Representative - Santa Monica

University of California; Santa Monica (CA); On-site; USD 42,000 - 55,000; Full time

Job summary

University of California is seeking a Patient Access Representative in Santa Monica to pre-register and admit patients by telephone or in person. You will collect accurate demographics, review insurance benefits, obtain prior authorizations, and liaise with public assistance programs such as Medi-Cal and CCS.

You will ensure Medicare requirements are met and assist with discharge planning and reimbursement processes.

Qualifications

• Knowledge of state and federal programs to ensure reimbursement
• Familiarity with third party payer verification terminology
• Understanding of payer follow-up processes and utilization review
• Ability to accurately process payments and cash receipts
• Typing 55 WPM and basic math proficiency

Responsibilities

• Pre-registers, pre-admits, and admits patients by phone or in person
• Collects demographic information and review insurance benefits
• Obtain prior authorizations and interact with public assistance programs
• Coordinate with Medicare, Medi-Cal, CCS and other agencies
• Refer cases to internal/external resources for discharge or post-hospital care
• Coordinate with Utilization Review and Patient Business Services for reimbursement

Skills

Medicare/Medi-Cal knowledge

Payer verification knowledge

Medical terminology

Typing speed 55 WPM

Basic math

Tools

Microsoft Excel

Microsoft Word

Outlook

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
• * Ability to type 55 words per minute (WPM)
• * Proficient in basic math
• * Proficient in Microsoft Office Suite, specifically Excel, Word, and Outlook

Note: May be subject to test on qualifying skills