Patient Access Specialist

kaweahhealth; Visalia (CA); On-site; USD 36,000 - 52,000; Full time

Job summary

Kaweah Health is seeking a Patient Access / Precertification representative to support admission, registration and pre-registration of patients. The role requires accurate data entry, adherence to HIPAA and privacy notices, and collaboration with medical staff for proper authorization and documentation.

Ideal candidates will have a high school diploma and experience in patient access, with Spanish bilingual skills advantageous for certain clinics.

Qualifications

• High school diploma required.
• Preference for college coursework related to health information or administration.
• Experience in patient access, registration, insurance benefits or medical terminology preferred.

Responsibilities

• Maintains confidentiality and protects sensitive data at all times.
• Adheres to safety standards and department guidelines.
• Completes admission, registration, or pre-registration processes for patients, documents HIPAA notices and patient signatures.
• Obtains signatures (HIPAA, COA, etc.) and collects copayments/deductibles.
• Works with physicians' offices to obtain orders and assist in authorization processes.

Skills

Communication

Data entry

Bilingual Spanish

Education

High school diploma

College courses (preferred)

Job description

Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care.

It takes a special person to work for Kaweah Health. We serve a region where the needs are great, which makes the rewards even greater. Every day, we care for people facing unique challenges and in need of healing. Throughout it all, our focus is to make a difference, and we do - in the health of our patients, our loved ones, and our community.

Benefits Eligible

Full-Time Benefit Eligible

Work Shift

Variable - 8 Hour or less Shift (United States of America)

Department

8590 Precert/Benefits Verification

Ensures high quality work of the registration process for patient care services with emphasis on service excellence to customers.

QUALIFICATIONS

Education

• Required: High school diploma
• Preferred: College courses

Experience

• Preferred: Prior patient access, registration, insurance benefit and medical terminology experience.

Knowledge/Skills/Abilities

• Excellent communication, customer service and data input skills.

Department Specific Requirements

• For Patient Access-Emergency Dept: requires Kaweah Health approved crisis intervention training within 60 days of hire/transfer.
• For Chronic Disease Mgmt Clinic: must be bilingual in Spanish.
• For Rural Health Clinics: requires Heartsaver AED.
• For Rural Health Clinics, Urgent Care Centers and GME-Family Medicine Center: prefer bilingual in Spanish, need to be determined by hiring leader at time of job opening based on clinic needs.

Testing

• For Rural Health Clinics & GME-Family Medicine Center (when testing required), and Chronic Disease Mgmt Clinic: Requires successful completion of the Language Resource Assistant (LRA) test at a General level. LRA is a language assessment test that demonstrates written and oral interpretation/translation technique skills. Test will be administered if selected.

JOB RESPONSIBILITIES

Essential

• Maintains confidentiality and protects sensitive data at all times.
• Adheres to organizational and department specific safety standards and guidelines.

Addendum (essential for specific dept)

• Accurately completes the admission, registration or pre-registration of a patient presenting for services. Obtains Advance Directive for Medical Record. Provides patient with written material as required by State and Federal law. Provides patient with Privacy Notice for HIPAA requirements. Obtains appropriate signature and documents accurately in Patient Management system as required for compliance. Must be accountable for the QA of own work. Utilizes all computer programs and procedures to ensure accuracy. Properly identifies correct patient and affixes an armband for positive identification of patient. Inventories patient belongings. Answers department phones, timely, and professionally. Assists customers timely with patient access concerns. Routes call as appropriate to other staff or location. Provides support for various floors as needed, in the absence of a unit secretary. Is productive during slow times. Ensures that all efforts provide value to and meet the needs of departmental customers. Responsible for securing patient belongings in accordance to the patient belongings policy. Works with physicians' office to obtain orders and assist in obtaining authorization. Understands Medicare coding, diagnosis codes, CPT codes to assure proper billing and use of ABN in order to provide as necessary to patient. Proficiency in the applicable programs. Thoroughly documents activity. Ensures patient has directions to facility/place of service. Answers all inquiries from all customers, both internal and external, in a timely manner whether the inquiries are via telephone, email, fax and in person. Informs patient of necessary requirements, financial obligations, financial discounts and pertinent information regarding their exam. Works closely with Financial Counselors to evaluate patient's financial needs, making appropriate determinations and referral to appropriate agencies for assistance to ensure reimbursement to the Kaweah Health.
• Obtains any signatures necessary including but not limited to HIPAA, COA, etc.
• Collects any applicable copayment or deductible and enters it into the patient payment system for a receipt.
• Answers questions regarding patient accounts.
• Properly identifies correct patient, correct exam and correct physician to ensure exam accuracy and patient confidentiality before services are provided to the patient.
• Obtains contact information for patients brought by ambulance or other transportation.

CHRONIC DISEASE MGMT CLINIC/RURAL H