Sutter Health Patient Access Representative (per diem) in San Francisco, California
California Pacific Medical Center. Hands-on Healing .
At San Francisco’s California Pacific Medical Center we deliver personal, hands-on care to every single patient, every single day. As one of California’s largest private, community-based, not-for-profit, teaching medical centers, we research the most up-to-date treatments, hire the most qualified individuals, and practice the most modern, innovative medicine available. We deliver the highest quality expert care, with kindness and compassion, in acute, post-acute and outpatient services, as well as preventive and complementary medicine. We also provide disease counseling, family support and wellness treatments. Throughout the entire organization, every member of the CPMC team is committed to giving our patients the individual, hands-on attention they deserve. Every hand plays a part, and every hand has the power to change a life. www.cpmc.org at http://www.cpmc.org/
PRIMARY PURPOSE: Under the general direction of the Supervisor and / or Manager of Patient Registration Services, this position is responsible for collecting and entering patient demographic and insurance information into the medical center’s registration computer system.
Service Standards: Consistently exhibits Service Standard behaviors set forth in the attached Service Performance Standards (see attached listing).
Complete patient pre-admissions / registrations and admissions / registrations in accordance with PRS Department policies / procedures job aids in a timely and accurate manner (approximately 7 – 10 minutes for inpatients and 3-5 minutes for outpatients).
Check the accuracy of registrations and correct errors by the end of their shift.The maximum acceptable daily error rate, for each Patient Registration Coordinator, is 5% or less for inpatients and 10% or less for outpatients.
Note:Errors that are corrected by the Patient Registration Representative before the close of their shift will not be included in their daily error rate.
Confirm insurance authorization for the following patient types, daily:
Scheduled Admissions / ASU / SDC:Authorization for these patient types are usually provided by the Physician office. Visually inspect each admission order to confirm that the authorization is in place for the patient’s scheduled procedure.Follow up with the Financial Counselor to notify the physician’s office / insurance company to obtain authorizations that are not on file.
Urgent / Direct Admission:Follow up with Financial Counselors to notify and obtain authorizations within 24 hrs of admission, from applicable insurance carrier.
Note that this process may require coordination with the Clinical Resource Management (CRM) personnel.
Answer patient questions regarding the Patient Bill of Rights, Medicare Bill of Rights, HIPAA and ABN.Obtains patient signatures when applicable (e.g. consent forms and Notice of Privacy acknowledgement form).
Comply with Government, Medical Center, and Sutter Health Policies and Procedures at all times.
Must be able to interview patients / family to obtain the required patient and guarantor demographic and insurance information.
Must be able to accurately and efficiently enter this information into the Patient Registration system.
Must demonstrate effective and sensitive communication with patients, physicians, other customers and co-workers as measured by no legitimate patient / other complaints per year.As needed validate that the patient understands the information and instructions you are providing.
Will maintain accurate and thorough account comment documentation in the Patient Financial System.
Must be able to explain financial requirements to patients / guarantors; coordinate patient registration and insurance information with the ancillary departments.This includes communicating referrals for financial assistance or Medi-Cal.
Inpatient Admission with a 95% accuracy rate.
Outpatient Registration with a 90% accuracy rate.
Be willing to cross-train in other areas as needed / requested
Employees performing this job function must have the following:
· High-level knowledge of Government regulations and requirements, managed care contracts and third party requirements.
· Demonstrated knowledge of the PRS and medical office / hospital admission processes.
· Basic knowledge of medical terminology
Skills and Abilities
Employees performing this job function must have the following:
· Excellent English communication skills in both written and verbal formats.
· General understanding of Patient Registration Systems
· Completed a minimum of the Microsoft Level 1 classes in Outlook, or be able to pass the PFS proficiency exam - level 1.
· Ability to identify patients that may need financial assistance and make referrals to appropriate resources.
Employees performing this function must have the following:
· High school diploma or GED.
· One year of prior hospital or medical registration experience required
Primary Location: California, San Francisco, San Francisco
Organization: California Pacific Medical Center
Employee Status: Regular
Employee Referral Bonus: No
Position Status: Non-Exempt
Job Shift: Day/Evening
Shift Hours: 8 Hour Shift
Days of the Week Scheduled: Varied Days
Weekend Requirements: Saturday-Sunday
Schedule: Per Diem
Hrs Per 2wk Pay Period: Varied
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.