Patient Assistance Representative- PRN

Profile

Patient Assistance Representative- PRN
Department:
Radiology Admin
Location:
Rio Rancho, NM
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Job Summary and Scope
Register and/or admit patients to **MEMBERS ONLY**SIGN UP NOW***.. Obtain and enter into the system all information necessary to create a complete and accurate patient account. Ensure that appropriate and necessary notifications are made to insurance carriers or agencies. Advise, inform and assist patients before, during and after their date of service. Ensure adherence to Hospitals and departmental policies and procedures. No patient care assignment.
Essential Functions:
POLICIES AND PROCEDURES - Maintain established departmental policies and procedures, objectives, and quality assurance programs
PROFESSIONAL DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops.
Interview patients and/or family at time of pre-admission, registration, admission, or discharge to obtain accurate demographic and financial information. Update information on Hospital computer system to ensure correct billing.
Schedule any new or follow up appointments
Obtain proper signatures for Medicare Rights, Consent for Treatment, financial assistance forms, and other forms as appropriate. Assure that the Patient Rights statements are distributed.
Verify insurance eligibility and restrictions to include referrals, prior authorization and financial assessment as required, may process patient discharge to include obtaining referrals, scheduling tests and other related activities.
Verify insurance and benefits; provide notification to appropriate payer entities within time frames established by the payers.
Obtain prior authorizations for same day surgery and other outpatient surgery patients as needed.
Acquire the appropriate ICD-10-CM code and medical history documentation required to obtain the prior authorization.
Update all hospital systems with correct information, calculate the co-payment for the service and collect out-of-pocket balances from the patient prior to service.
Determine eligibility and process applications for financial assistance, including but not limited to; Medicaid, SCI, SRMC programs, Commercial, Medicare, PHS/Indian Health Service, SALUD and Self Pay.
Maintain knowledge of community financial resources and refer patients appropriately.
Answer phones and assist walk-in patients as needed.
Assist with special projects and assignments.
Perform miscellaneous job-related duties as assigned.
SRMC Core Values
Integrity:
Our words and actions match our values
To Serve:
We put the needs of others before our own
Excellence:
We strive to exceed expectations and/or standards in every activity, every encounter, and every initiative
Safety/Quality:
We provide evidence based care, programs, services, and an environment that achieves the best outcomes
Teamwork:
We enjoy the ability and power to work collaboratively to deliver exceptional service
Accountability
Position doesn’t have the scope of decision making, budget, assets and planning responsibilities.
Communication Skills
Skill to communicate and interact with patients, families, physicians and staff
Good written and verbal communication skills
Ability to be aware of and sensitive to cultural and bilingual issues
Required Qualifications
Knowledge of principles and processes for providing customer and personal services to pediatric, adolescent, adult and geriatric patients
Knowledge of mathematics
Skill in applying independent judgment
Good organizational skills
Ability to work effectively under stressful conditions and irregular hours
Ability to interpret and assess data effectively
Ability to multi-task and complete assignments
Ability to be aware and respond to patient needs
Education/Experience
Education:
High School Diploma or GED equivalent
Preferred Educational/Experience Requirements:
Two (2) years registration, admitting, business office or related work experience
Bilingual English/Spanish
Conditions of Employment
Must pass a pre-employment criminal background check, reference checks and a post offer drug screen.
Must be employment eligible as verified by the U.S. Dept. of Health and Human Services Office of Inspector General (OIG) and the Government Services Administration (GSA).
Tuberculin Skin Test required annually
Hospital required vaccinations
Hospital required competencies
Working Conditions
Typical office and/or patient care, acute care hospital environment.
Must be able to travel locally between facilities and within the surrounding community.
Occasional exposure to minimal physical risk
Extensive travel
Substantial overtime
Evening meetings
On-call status
Exposure to contagious disease
Exposure to chemicals
Heavy lifting
Constant standing
Extensive close work
Extensive computer work
Dealing with hostile, upset people
Dealing with grief and sorrow
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