Providence St. Joseph Health

Job Information

St. Joseph Health / Covenant Health Senior Patient Access Representative in Irvine, California

We are looking for a Senior Patient Access Representative with PTAccess Clrnc(Pre-Reg)SCCOOP at Revenue Cycle Services LLC.

Location: Irvine, California

Schedule: On Call/ Per Diem - Biweekly

Shift: 8-Hour, Days

Job Summary:

Under the direction of the Manager of Patient Access, the Senior Patient Access Representative is responsible for pre-registration and financial clearance activities. This position is responsible for collecting and documenting required patient demographic and financial data elements for scheduled visits and completing pre-service collections. This position is also responsible for verifying patient insurance, confirming benefits eligibility, and performing authorization, pre-certification, and/or notification as required by third-party coverage providers. In addition to daily pre-registration and financial clearance functions, the Sr. Patient Access Representative should serve as a functional expert for department peers.

Essential Functions:

  • Obtain/confirm and enter demographic and other financial and clinical information necessary for financial clearance of scheduled patient accounts.

  • Contact patient’s family or physician offices to obtain missing insurance information which can include policy number, group number, date of birth, and insurance phone number if patient does not have insurance cards during emergent/urgent admission.

  • Verify insurance using online electronic verification system or by contacting payor directly.

  • Confirm and document insurance eligibility of patient coverage benefits, including coverage limits, number of days, patient responsibility, effective dates, and follow-up with patient and/or referring physician office in the event of failed eligibility.

  • Collaborate with scheduling departments to identify add-on patients (patients scheduled for services less than two days from booking date).

  • Obtain authorization, pre-certification, referral, and/or notification as necessary.

  • Notify patients of their liabilities prior to date of service as determined by insurance benefits and coverage limits; collect liabilities per department guidelines.

  • Daily focus on attaining productivity standards; recommend new approaches for enhancing performance and productivity when appropriate.

  • Maintain appropriate records, files, and timely and accurate documentation in the system of record.

  • Act as a knowledgeable resource on Pre-Registration and Financial Clearance functions for department staff. (e.g., answer account questions, assist with new staff training, etc.)

Minimum Position Qualifications:

  • 3 or more years of financial clearance and/or pre-registration experience.

  • Ten-key touch.

  • Knowledge of computer software programs and use of basic office equipment.

Preferred Position Qualifications:

  • High school diploma or GED.

  • 5 years pre-registration and financial clearance experience.

  • Certification as a Certified Revenue Cycle Representative (CRCR) by the Healthcare Financial Management Association (HFMA), or related certification.

  • Bilingual English/Spanish.

St. Joseph Health (SJH) is an integrated healthcare delivery system sponsored by the St. Joseph Health Ministry and organized into three regions: Northern California, Southern California, West Texas/Eastern New Mexico.SJH provides a full range of care from facilities including 14 acute care hospitals, home health agencies, hospice care, outpatient services, skilled nursing facilities, community clinics, and physician organizations.SJH maintains a 'continuum of care,' matched to the diverse needs of the urban centers, smaller cities and rural communities in three statesFor the third year in a row in 2009, the Gallup Organization awarded St. Joseph Health its highest honor - the Great Workplace Award.SJH provides exceptional benefits, opportunities for advancement and relocation within the system.St. Joseph Health is comprised of four core values: Service, Excellence, Dignity, and Justice are the guiding principles of all we do.Excellent compensation program and benefits provided.St. Joseph Health (SJH) provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics.In addition to federal law requirements, St. Joseph Health (SJH) complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities.This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.Positions specified as “on call, per diem” refers to employment consisting of shifts scheduled on as “as needed basis” to fill in for staff vacancies.

Company: SJH System Office

Category: Administrative (Clinical)

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