San Antonio, TX – Telecommute
Patient Access Central Unit Representative – Work From Home
The PTAC Central Unit Representative is responsible for timely and accurate processes associated with some or all of the following:
Duties (included but not limited to):
Duties will be performed by each individual depending on assignment of responsibilities:
Perform preregistration and insurance verification within 3-5 days prior to date of service for both inpatient and outpatient services. For notifcation received with less than 3 days’ advanced notice perform within 24 hours of notification.
Follow scripted benefits verification and pre-certification format in Meditech custom benefits screen and recordbenefits and pre-certification information in the approved standard format
Assign Insurance Plans (IPlan’s) accurately
Perform electronic insurance eligibility confirmation when applicable and document results
Complete Medicare Secondary Payor Questionnaire as applicable for retention in imaging system (i.e. OnBase)
Calculate patient cost share and be prepared to collect via phone or make payment arrangement
Contact patient via phone (with as much advance notice as possible,preferably 48 hours prior to date of service) to confirm or obtain missing demographic information,quote/collect patient cost share, and instruct patient on where to present at time of appointment
Receive and record payments from patient for services scheduled.
Utilize appropriate communication system to facilitate communication with hospital gatekeeper
Ensure appropriate documentation is entered in standard format on the patient record. This should be performed inthe applicable Health Information System (i.e. Meditech) and if necessary any other subsidiary systems if they are notautomatically updated.
Contact physician to resolve issues regarding prior authorization or referral forms
Research Patient Visit History to ensure compliance with payor specific payment window rules
Perform insurance verification and pre-certification follow up for prior day’s walk inadmissions/registrations and account status changes by assigned facility as per SSC guidelines.
Communicates with hospital based Case Manager as necessary to ensure prompt resolution of pre- existing, non-covered, and re-certification issues
Meets/exceeds performance expectations and completes work within the required time frames
Implements and follows system downtime procedures when necessary
Practice and adhere to the ?Code of Conduct? philosophy and ?Mission and Value Statement?
Other duties as assigned
KNOWLEDGE, SKILLS & ABILITIES
Communication- communicates clearly and concisely, verbally and in writing. This includes utilizing properpunctuation, correct spelling and the ability to transcribe accurately.
Customerorientation- establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
Interpersonalskills- able to work effectively with other employees, patients and external parties
PCskills – demonstrates proficiency in Microsoft Office applications and others as required
Policies & Procedures – demonstrates knowledge and understanding of organizational policies, proceduresand systems
Basicskills – demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes,have ability to work quickly and accurately in a fast-paced environment while managing multiple demands, ability towork both independently and collaboratively as a team player, adaptability, analytical and problem solving ability andattention to detail and able to perform basic mathematical calculations, balance and reconcile figures, punctuateproperly, spell correctly and transcribe accurately.
High school diploma or GED required.
Customer Service , Insurance , Insurance Claims , Medical & Health , Medical Billing
San Antonio, TX