Job description
Access Care Representative A, WMCUnited Health Services is seeking Access Care Representative A to join our WMC Access Care Team in Johnson City, NY. This is a BENEFITS-ELIGIBLE position.
Shift: Varies
Hours per week: 36
Salary range: $16.35- $22.13/hour, depending on experience
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Access Care Representative A Overview
Under supervision, performs secretarial duties, utilizing knowledge of medical terminology and hospital, clinical, or laboratory procedures.
Access Care Representative A Key Responsibilities and Expectations
Completes registration fields for all patients who are to be pre-registered a minimum of two (2) business days prior to their scheduled appointment; Handles all ER, outpatient walk-in or add-on appointments as well as Inpatient or Observation admission registrations.
Updates and maintains the hospital census and bed board system according to physician and nurse requests.
At times, may assist with scheduling patients for applicable appointments and coordinates the completion of all applicable fields.
Documents contact with insurance carrier, other staff, or patient in Soarian Financial, along with result of precertification request. Documentation should include but is not limited to, demographics and insurance information.
Contacts physician, physician office, or patient to resolve issues regarding prior authorization or related information.
Assigns health plans accurately and research patient related encounters to ensure all assigned health plans are linked.
Performs electronic eligibility confirmation when applicable and document results.
Completes Medicare Secondary Payor Questionnaire as applicable for retention in Soarian.
Contacts patient via phone (with as much advance notice as possible, preferably 48 hours prior to date of service) to confirm or obtain missing demographic information and instructs patient on where to present at time of appointment.
Calculates patient cost share and is prepared to collect via phone, face to face or make payment arrangement; Receives and records payments from patient.
Communicates with Financial Advocacy Team as necessary to ensure prompt assistance with patients without insurance.
Researches and appeals insurance carrier denials by reviewing denial reason codes to determine cause; updates encounter appropriately after denial cause is identified and allows encounters to be reprocessed for payment.
Assists in the preparation of patients’ medical record for ambulatory and inpatient surgical cases.
Maintains a high knowledge level on all insurance payers, including managed care, governmental, commercial, no fault, workers’ compensation, etc.
Demonstrate commitment to organizational Values of Compassion, Trust, Respect, Teamwork, and Innovation.
Position Qualifications
Minimum:
High School Diploma or equivalent, with two (2) years’ experience in similar field
Preferred:
Associate’s Degree, or 5 years equivalent experience in lieu of degree
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