Pre-Access Representative
Rochester Regional Health

Description

HOW WE CARE FOR YOU

At St. Lawrence Health, we are dedicated to getting health care right. Our robust benefits and total rewards foster employee wellbeing, professional development and personal growth. We care for your career while caring for the community.

• Same Day pay through Daily Pay
• Paid vacation & holiday pay
• Medical, dental, vision, hearing benefits

SUMMARY

The Pre-Access Representative will be responsible for handling the flow of scheduling calls. The essential responsibilities include pre-registration, scheduling, obtaining accurate demographics, providing exam preparations, and collection of appropriate authorizations/ICD codes in a courteous and efficient manner. They will be responsible for completing accounts with eligible insurance and authorization and complete patient pre-registration for scheduled procedures. The Representative will verify the patient payer eligibility, benefits/coverage, and estimated payment responsibility, confirm authorization requirements and secure on the account. The Representative will complete pre-registration phone interviews, to include obtaining necessary pre-registration information, including demographics, insurance information, and Medicare MSPQ, with documentation completed in the electronic medical record account. During the pre-registration interview, the representative will notify patient of potential financial responsibility and collect payment via phone, review issued Medicare ABN (Advance Beneficiary Notification), provide direction to facility and registration desk, and educate the patient regarding what items are required as part of the patients facility registration process.

Canton-Potsdam Hospital is a warm and caring not-for-profit community healthcare facility that's certified for 94 beds. Our mission is to provide exceptional healthcare services to the community. Within our welcoming walls, you'll find a wide array of core programs in emergency medicine, acute care, hospitalist medicine, and critical care. But that's just the beginning. We're not just a hospital; we're a beacon of health and wellness in the North Country. We proudly offer outpatient health services in Brasher Falls, Canton, Colton, Gouverneur, Massena, Norfolk, and Potsdam, NY.

STATUS: Full time

LOCATION: CPH

DEPARTMENT: Physician Practice Management

SCHEDULE: 8 Hour shift

ATTRIBUTES

• Required: High School Diploma or GED required
  
• Preferred: Associate degree
  
• Preferred: 1-2 years' work experience in a medical practice
  
• Preferred: Experience with electronic medical record
  

RESPONSIBILITIES

• Patient Care Management: Obtain and accurately record all relevant information, such as demographics, forms, etc. and ensure it is accurate and thorough in the patient's electronic medical record (EMR)
  
• Assure that all patient encounters, whether in person, electronically, telephonic or via other communication links are documented in a professional, timely and accurate manner
  
• Review patient EMRs and prepare for upcoming patient encounters to ensure practice is prepared with resources as necessary
  
• Responsible for all incoming and outgoing referral management
  
• Coordinate services for patients as requested by the provider
  
• Responsible for managing and obtaining prior authorizations as required by relevant insurance companies or other providers/vendors for ancillary services and in office procedures prior to the delivery of services
  
• Responsible for scheduling Operating Room procedures and ensuring that prior authorizations and the booking sheet are sent to the Pre-Admission Testing team
  
• People: Establish and maintain positive relationships, as well as provide open and clear communication, with care team and management, as well as any person involved in delivering high quality patient care
  
• Promote and uphold relationships and collaborate with staff, providers, leadership and other vendors as required to maintain an effective work environment
  
• Regulatory: Works with Physician Practice Management (PPM) team to comply with all established standards required under the accreditation standards of Det Norske Veritas
  
• Knowledgeable of state and federal healthcare standards, as appropriate
  
• Accesses appropriate resources through the PPM Management team regarding DNV standards, federal (CMS), State of New York statues, rules and regulations under all applicable federal and state, departments and acts collaboratively with PPM leadership team
  
• Resolves problems and ensures compliance with medical regulations and office standards of quality patient care and customer service
  
• Adheres to Canton-Potsdam Hospital and PPM policies, procedures, protocols , guidelines, etc.
  
• Training and Development: Participates in team meetings
  
• Participates in on-going education activities to develop, maintain, and enhance professional expertise as monitored by supervision
  
• Meets and abides by CPH Mission, Vision and Values
  
• Works with PPM Management to resolve issues (Processes, performance, etc.) to identify opportunities for improvement
  

PHYSICAL REQUIREMENTS: S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

PAY RANGE: $18.24 - $26.77

The listed base pay range is a good faith representation of current potential base pay for successful applicants. It may be modified in the future. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity / Affirmative Action Employer. Minority/Female/Disability/Veteran

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