At Saint Alphonsus Health System, we are looking for people who are living out their calling. We want you to be passionate about coming to work and challenged to achieve your potential. Living by these virtues, we pride ourselves on exceptional service and the highest quality of care.
Under the guidance of the manager, this position is expected to perform a higher level of generally more complex job specific responsibilities. When appropriate greets patients and family members in a professional and courteous manner. Obtains, and verifies demographic, clinical, financial, and insurance information during the (pre)-registration process including scheduling tasks, accepts point of service payments or provides guidance for payment options, and clears the patient for service delivery. Acts as the primary point of contact between infusion clinic team and Patient Access management.
SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:
- High school diploma or equivalent required.
- Associate degree or an equivalent combination of education and experience preferred.
- Past work experience of at least 2 years within a healthcare provider and/or payer environment performing patient access and/or customer service activities, are highly desired but not required.
- Certified Healthcare Access Associate (CHAA) credentials by the National Association of Healthcare Access Management (NAHAM) and Certified Patient Account Technician (CPAT) credentials by the American Association of Healthcare Administrative Management (AAHAM) is also preferred.
- Data entry skills (50-60 keystrokes per minutes) preferred.
- Knows, understands, incorporates, and demonstrates the Organization's Mission, Vision, and Values in behaviors, practices, and decisions.
- Performs accurate insurance verification, pre-authorization, scheduling, and patient estimates in advance of patient care
- Provides scheduling and registration services for inpatient and outpatient departments of SAHS facilities
- Schedules procedures and visits from Epic appointment request work queues in compliance with business line and clinic-specific workflows, in coordination with each department's specified patient care and provider needs
- Ensures patient safety by authenticating patient identity throughout all essential functions.
- Determines financial responsibility through patient estimate calculations, and communicates to patients prior to service date, including network benefits, out-of-pocket costs, as well as Good Faith Estimate for uninsured patients in compliance with the No Surprises Act
- Informs patient/guarantor of their liabilities and collects appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits, and outstanding balances at the point of scheduling and pre-registration. Calculates patient liabilities and provides financial education, referring the patient to financial counseling, as required. Documents payments/actions in the patient accounting system and provides the patient with a payment receipt in the collection of funds.
- Obtains and validates required referral information, including physician orders, clinical records, demographic, and benefit and eligibility information
- Meets payor pre-authorization requirements to secure full insurance or government payer reimbursement.
- Documents all required scheduling, financial clearance, and registration information, including patient estimate, in appropriate Epic modules, to ensure a complete and legal record is recorded
- Provides courteous and efficient service to patients via telephonic and face to face interaction, accurate documentation/verification of patient pre-registration information, and professional and timely communications with medical staff and administrators
- Meets or exceeds established customer service, productivity, and quality standards in all essential functions.
- Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health's Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
- Assists in denials reduction through review and research of registration, authorization or medical necessity claims denials as needed; reports findings to department manager
- Communicates with patients, physicians, payers, families, financial counselors, transitional care or transfer center staff, or other SAHS Health partners
- Performs other related duties as assigned
Colleagues of Saint Alphonsus Health System enjoy competitive compensation with a full benefits package and opportunity for growth throughout SAHS and Trinity Health!
Visit www.saintalphonsus.org/careers to learn more about the benefits, culture, and career development opportunities available to you at Saint Alphonsus Health System.
Visit Saint Alphonsus on LinkedIn, Facebook, Instagram, YouTube, and Twitter!Saint Alphonsus and Trinity Health are committed to promoting diversity in its workforce and to providing an inclusive work environment where everyone is treated with fairness, dignity and respect. We are committed to recruit and retain a diverse staff reflective of the communities we serve. Saint Alphonsus and Trinity Health are equal opportunity employers and prohibit discrimination against any individual with regard to race, color, religion, gender, marital status, national origin, age, disability, sexual orientation, or any other characteristic protected by law.Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.