CVMP-Patient Access - Patient Access Rep.
Position Summary:
Directs and coordinates all work activities of San Ysidro Health. Responsible for performing variety of functions which involve the activities of the front office including X-rays, Behavioral Health, Laboratory and Chiropractic. Answer telephones, greets, assists and directs visitors, patients and other clinic office callers. Guides, screens, and registers new patients. Assists patients in obtaining services and provides information on funding eligibility. Inquiries related to patient access processes, policies, and/or other related information.
Essential Functions of the Job:
- Provide assistance to the front office duties and responsibilities, including registration, appointment and the check-in process.
- Maintain Patient Service Representative (PSR) productivity quality at or above satisfactory level, including efficiency service to the patients.
- Maintain direct communication with PSRs and review daily and monthly co-pays analysis with staff and reduce claim denials to San Ysidro Health standards.
- Provides appropriate technical training to new and existing PSR’s with technical updates and guidance to maintain quality measures to San Ysidro Health standards.
- Conduct monthly customer service audits and communicate positive constructive feedback to the Patient Service Representative to maintain high level of excellence in customer service.
- Prepare reports requested by supervisor/manager where information must be obtained from a variety of sources, including monthly SFD audit reports within a timely manner.
- Works closely with Nursing, Medical Records and Provider Schedule Coordinator to ensure smooth patient flow transition.
- Assists in care and maintenance of department equipment and supplies.
- Review employees approved vacation for appropriate coverage.
- Interacts with staff on a consistent basis to assist with technical or patient questions.
- Assesses patient financial responsibility and collects co-pays and deductibles at time of
- check-in.
- Obtains and documents funding information from patients and provides information on
- available funding resources.
- Uses payer resources (RTS) and websites to explore and access eligibility; initiates referrals for varies insurance such as Medi-Cal, Medicare, Manage Care, Commercial, etc.
- administers and determines patient eligibility for Sliding Fee Discounts Program.
- Building up the new provider’s patient panel. The PSR lead with the assistance of PSRs will be reaching out to patients proactively to ensure all provider schedules are full weekly.
- Maintains established departmental policies and procedures, objectives, quality assurance program, safety, environmental and infection control standards.
- Enhances professional growth and development through participation in educational programs, Current literature, in-service meetings and workshops.
- Attends meetings as required and participates on committees as directed.
- Performs other related duties as assigned or requested.
- Prioritize workload to maintain effective time management on a daily basis.
- Must be available at all hours of business operations, including weekends
Education Required (Minimum level of education):
High School or GED equivalent.
Certification/Licenses:
Required: CA Driver’s License and Insurance.
Experience:
Required: Two years + experience in a medical setting, preferably front desk, or reception.
Preferred: Two years + of customer service experience.
Verbal and Written Skills Required to Perform the Job:
Bilingual (Spanish-English) required; must have good handwriting and verbal communication skills.
Technical Knowledge and Skills Required to Perform the Job:
Must have verbal ability for accurate and tactful explanation.
Equipment Used:
Multi-extension phones; CRT/PC, and other office machines.
Working Conditions and Physical Requirements:
May be required to lift approximately 25 lbs. Mostly sitting position. May be required to work evenings and/or weekends or clinics outside of assigned clinic.
Universal Requirements
Pre-employment requirements include I-9, physical, positive background and reference check results, complete application, new hire orientation, pre-employment PPDs.
HIPAA/Compliance
- Maintain privacy of all patient, employee and volunteer information and access such information only on a need to know basis for business purposes.
- Comply with all regulations regarding corporate integrity and security obligations. Report unethical, fraudulent or unlawful behavior or activity.
- Comply with all regulations and required schedules regarding OSHA training.
- Required health screening to be performed annually.
- Responsible for following all San Ysidro Health policies and procedures.
- Punch out before 5 hours from the start of shift for meal periods.
- Comply with all regulations and required schedules regarding sexual harassment training.