Overview:
The perfect blend of exceptional care and comfortable accommodations, Clovis Community Medical Center remains a top choice for women's services, labor and delivery, advanced minimally invasive surgeries, sports medicine, and weight-loss surgery. Home to the Marjorie E. Radin Breast Care Center, California's premier breast care center, we offer screening, diagnostics, and treatments using the most cutting-edge technology available. We're a family-oriented, suburban hospital at the base of the Sierra Nevada Mountains that's part of the Community Medical Centers healthcare network. Expanded in 2012, Clovis Community has 208 all-private rooms - making Clovis Community the only comprehensive hospital in the area with all-private rooms.
Whether for inpatient or outpatient care, we're here to provide the best possible experience and the highest quality care for the people we serve. That means we are able to offer a variety of ways for you to grow - both in the way you do your job as a healthcare professional and in the way you live your personal life. If you share our passion for providing the best possible care for each and every patient, you should consider a career with our team at Clovis Community Medical Center.
Responsibilities:
*All positions are located in Fresno/Clovis CA*
The perfect blend of exceptional care and comfortable accommodations, Clovis Community Medical Center remains a top choice for women's services, labor and delivery, advanced minimally invasive surgeries, sports medicine, and weight-loss surgery. Home to the Marjorie E. Radin Breast Care Center, California's premier breast care center, we offer screening, diagnostics, and treatments using the most cutting-edge technology available. We're a family-oriented, suburban hospital at the base of the Sierra Nevada Mountains that's part of the Community Medical Centers healthcare network. Expanded in 2012, Clovis Community has 208 all-private rooms - making Clovis Community the only comprehensive hospital in the area with all-private rooms.
Whether for inpatient or outpatient care, we're here to provide the best possible experience and the highest quality care for the people we serve. That means we are able to offer a variety of ways for you to grow - both in the way you do your job as a healthcare professional and in the way you live your personal life. If you share our passion for providing the best possible care for each and every patient, you should consider a career with our team at Clovis Community Medical Center.
Provides intermediary customer service coverage, registration, and admitting in any point of service specialist areas and is responsible for patient information and insurance intake. Assigned intermediary duties include, but not limited to: appointment scheduling, registrations, direct admissions, insurance verifications, authorization notifications, multi-line telephone coverage, data entry, filing protected health information (PHI), referrals/physician orders, collections, and financial estimates, while maintaining quality patient/customer relations.
This is the second of three job levels that provide customer service, registration, and/or admissions to an assigned point of service area. The different levels of this job family are distinguished by the skills and experience required to perform the accountabilities, the complexity of problems solved as part of the job and the assigned level of responsibility.
Accountabilities
1. Promptly fields and responds to inquiries providing information to patients, patient families, other hospital departments, and medical staff according to established policies for CMC.
2. Answers telephone in a courteous and professional manner.
3. Provides proficient customer service skills by greeting and treating all patients and staff with respect and discretion.
4. Gathers and/or verifies all appropriate patient demographics, injury information, and financial information, including: insurance benefits, co-pays, deductibles, and financial programs.
5. Identifies and armbands patients correctly.
6. Performs Admissions, Direct Admissions, and bedside registrations for procedures and treatments.
7. Obtains all appropriate signatures: COA, HIPAA, etc.
8. Scans photo ID, insurance cards, COA, HIPAA, financial documents, etc. into hospital information system.
9. Establishes payment source through online verification system, insurance website, or phone call to insurance company. Determines appropriate insurance plan, financial class, and insurance guarantors required for billing.
10. Notifies insurances, within their specified time frames, for authorizations.
11. Holds sufficient understanding of insurance protocols for co-payments, deductibles, allowances, etc. Analyzes information received to determine patients’ out-of-pocket liabilities.
12. Sufficient knowledge of CMC's contracted vs. non-contracted insurance payors.
13. Performs estimates through hospital information system and informs patient of their financial responsibilities.
14. Collects upfront payments toward patient’s financial responsibilities. Handles daily deposits and balance cash drawers.
15. Ensures that all information is complete and accurately entered into the health information system.
16. Knowledge of federal, state, and local agencies requirements in order to meet regulatory compliance for documents as well as refer patients appropriately.
17. Performs other job-related duties as assigned.
Knowledge, Skills and Abilities
- Advanced clerical and customer service standards.
- Standard knowledge of current policies and procedures and regulatory compliance.
- Proven knowledge of Medical Terminology obtained from previous work experience or class.
- Advanced skills in data entry.
- Correct English usage in spelling, grammar, punctuation, and vocabulary.
- Read and comprehend office or program instruction manuals and reports.
- Compose and use proper formats for a variety of correspondence, reports, instructions, and other documents.
- Proficient customer service skills with the ability to deliver friendly and efficient customer service to all patients, visitors, and staff.
- Ability to multi-task and use critical thinking skills for problem solving in a high demanding environment.
- Proficient with MS Office applications (e.g., Excel, Word, etc.).
- Sufficient knowledge of third party payers, including: federal, state, and private health plans.
Education
- High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required
Experience
- 2 years of experience as a Patient Access Representative and/or previous work experience in a related field required
Other Qualifications / Notes
Special Conditions
- Must be able to work various hours, days, shifts, on-call, and various locations based on the 24-hour Medical Center’s business needs.
- Pay ranges listed are an estimate and subject to change.
- If any bonuses are noted, they are only applicable to external hires meeting criteria.
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