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Vail Health · 10 hours ago

HHSM - Patient Access Representative

Frisco, Colorado, United States

Full-time

Onsite

New Grad, Entry Level

$20.67/hr - $24.37/hr

Vail Health is a leading mountain healthcare system providing exceptional care in a state-of-the-art facility. The Patient Access Representative is responsible for patient registration, admissions, and managing insurance-related tasks, while ensuring excellent customer service and compliance with healthcare regulations.

Health CareHospitalMedicalNon ProfitOncologyTherapeuticsWellness

Responsibilities

Registers patients and performs all registration-related functions, including explaining and obtaining all necessary patient consents and authorizations in a complete and timely manner, and collecting financial paperwork (e.g., patient responsibility statement, etc.) and co-payment as required

Communicates effectively with patient to assist in access to care by: answering telephone and other incoming communications in a timely and customer-service oriented manner; replying to inquiries, patient needs for information, and other parties clearly and in a timely manner; and, if information is not readily available, follows up with inquiries to responsible party

Resolves all non-clinical questions within scope of knowledge while providing excellent customer service on the phone and/or in person

Performs on-going documentation audits for medical necessity, plan of care, and other related tasks or requirements by payors, including Medicare, using a variety of computer-based systems

If in a procedure-based department, routinely schedules appointments for all procedures educating each patient with pre-exam and if necessary, post-exam requirements within scope. Organizes, generates and distributes patient reminders, results, and recall letters

Establishes files, maintains information, and scans medical records in a timely and organized manner

Manages, directs and responds to incoming office correspondence as deemed appropriate, including mail, email, faxes, and telephone calls and forward queries to the appropriate staff

Organizes, monitors, and orders front desk supply inventory to assure cost effective departmental spending

Attends and provides feedback for departmental staff meetings

Follow the Center for Medicare & Medicare Services (CMS) requirements for checking medical necessity communicates relevant coverage/eligibility information to the patient. Identifies patients who will need Medicare Advance Beneficiary Notices (ABNs) of non-coverage and maintains accurate records of authorizations within the EMR

Completes Medicare Secondary Payer Questionnaire for Medicare beneficiaries in accordance with Centers for Medicare & Medicaid Services (CMS) standards

Role Models the Principals of a Just Culture and Organizational Values

Ensures compliance with all applicable HIPAA, EMTLA and Joint commission requirements, providing required associated literature to patients

Performs other duties as assigned on department and organizational-level

Qualification

Customer service experienceClerical experienceComputer skillsEnglish proficiencyCommunication skills

Required

Customer service and clerical experience

Must possess, or be able to obtain within 90 days, the computer skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc

Must have working knowledge of the English language, including reading, writing, and speaking English