Patient Access Service Representative I - Inpatient Admitting
Provides excellent customer service by serving as the initial patient point of contact for TMC HealthCare and the Business office; interviews patients, gathers information, contacts insurance payers to secure eligibility and/or authorizations for services rendered, assists with insurance/hospital questions, prepares admission forms, and enters patient data into the Patient Accounting System.
and staff; adheres to and supports team members in exhibiting TMCH values of integrity, community, compassion, and dedication.
Interprets and explains to patients and their families’ charges, services, and hospital policy regarding payment of bills.
Collects deposits or deductibles as required and advises patient or guarantor of insurance benefits and anticipated cost estimates; ensures cash handling follows corporate policies.
Ensures completion of financial documentation in accordance with TMCH’s credit and collection policies.
Explains all necessary compliance forms and obtains patient signature as required for regulatory agencies.
Performs medical necessity screening and ensures compliance with system requirements, as applicable.
Compiles and distributes information regarding patients’ personal, insurance, and financial status; provides forms to appropriate staff.
Reviews hospital pre-admissions to ascertain and verify hospital coverage and eligibility.
Contacts insurance carriers and patients by telephone for appropriate billing information such as insurance identification numbers.
Documents all notification, authorization and eligibility information in the registration systems; uses electronic verification tools and web-based resources.
Maintains appropriate filing systems, records, reports, and confidential files to ensure quick retrieval of information.
Reconciles daily cash drawer.
TMCOne Front Desk – Assists medical care givers with patient management, tracking and monitoring requirements. Answers phones, pre-screens using appropriate triage skills, within allowable parameters calls in prescription re-fills, calls patients with test results and schedules patients for next appointments.
Adheres to TMCH organizational and department-specific safety and confidentiality policies and standards.
Performs related duties as assigned.
EDUCATION: High School diploma or General Education Degree (GED), or an equivalent combination of relevant education and experience.
EXPERIENCE: Preferred minimum of one (1) year of related experience and knowledge of third party payers and AHCCCS guidelines. Applicants must have basic computer familiarity and experience.
LICENSURE OR CERTIFICATION: None Required.
KNOWLEDGE, SKILLS AND ABILITIES:
Knowledge of office management practices, including billing and scheduling within healthcare.
Knowledge of basic computer familiarity and experience and the ability to operate basic office equipment.
Skill in evaluating patient’s needs or following up with a care-giver and then providing follow up support to patients.
Ability to read or listen and comprehend simple instructions, short correspondence, and memos.
Ability to write simple correspondence; ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
Ability to read and interpret documents such as safety rules, procedure manuals, and governmental regulations.
Ability to effectively present information and respond to inquiries or complaints from patients and/or their representatives and the general public.
Ability to provide excellent customer service via phone and walk-ins.
Ability to interpret and explain insurance benefits and patient financial responsibility.
Ability to apply common sense understanding to carry out simple/detailed written or oral instructions.