Patient Access Rep

In 2020, united in a fierce commitment to deliver the highest quality care and exceptional patient experience, Virginia Mason and CHI Franciscan Health came together as natural partners to build a new health system centered around the patient: Virginia Mason Franciscan Health. Our combined system builds upon the scale and expertise of our nearly 300 sites of care, including 11 hospitals and nearly 5,000 physicians and providers. Together, we are empowered to make an even greater impact on the health and well-being of our communities.

CHI Franciscan and Virginia Mason are now united to build the future of patient-centered care across the Pacific Northwest. That means a seamlessly connected system offering quality care close to home. From basic health needs to the most complex, highly specialized care, our patients can count on us to meet their needs with convenient access to the region’s most prestigious experts and innovative treatments and technologies.

Job Summary:

• This job is responsible for performing a variety of general administrative support duties associated with the patient intake process for the Franciscan Medical Group (FMG) outpatient clinics in accordance with established internal guidelines and procedures. Incumbents typically interact with patients directly at the front desk and/or on the phone to perform follow-up activities.
• Work includes: 1) ensuring patient is checked in/out for care; 2) collecting and entering demographic and financial data in the patient’s medical record; 3) gathering/validating insurance information using routine methods, scheduling patient appointments; 4) collecting co-pays, co-insurance and prior balances; 5) obtaining and processing of referrals, authorizations and pre-certifications for patients requiring ancillary testing and/or surgical procedures; and 6) working with patients to ensure the patient’s referral needs are fulfilled and determining insurance benefit coverage for hardware related items such as retail contact lenses by working directly with patients’ insurance carriers, ever needed.
• Work requires critical thinking, hearing the needs of the patient meeting those needs by offering multiple options and solutions, knowledge of insurance authorization/billing requirements and privacy/confidentiality practices, as well as knowledge of medical terminology and the patient intake process. An incumbent following proper channels of communication in handling daily and routine problems and recognizing issues that need referral to management. Strong customer service skills are required offering the highest level of service to every patient every time.
• An incumbent is generally located either behind-the-scenes, interacting with patients on the phone or at the front desk, interacting with patients directly.
• This job exists in multiple locations, and while there may be minor differences in job content, they are not significant for classification purposes. Overall, the nature of the work and job requirements is consistent between locations.

Essential Duties:

• Registers and/or checks patients in/out.
• Handles and reconciles payments.
• Continually monitor and reconcile issues prior to patient visit.
• Processes referral orders and/or pre-authorizations
• Coordinates appointments and ancillary services
• Responds to patient questions regarding routine billing and insurance matters
• Coordinates patient instructional/educational activities.
• An incumbent is located either behind-the-scenes, interacting with patients on the phone or at the front desk, interacting with patients directly.
• Performs related duties as required

Education/Work Experience:

• One year of customer service work experience is required, two years preferred. Healthcare or Call Center experience preferred.