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Sharp HealthCare is actively seeking a patient Access Services (PAS) representative to improve its outpatient registration process and provide excellent customer service. This crucial role involves managing various aspects of the revenue cycle, from initial pre-registration to handling referrals and resolving potential claim denials. The position requires a detail-oriented person capable of handling insurance verification and cash collection,while ensuring patient safety within the ancillary department. The role offers a variable shift schedule and an hourly pay range from $24.50 to $34.30.
Key Responsibilities and Duties
The Patient Access Services representative is vital in managing patient details,verifying insurance benefits,and collecting payments. A high school diploma or equivalent is required, with HFMA certification preferred. The representative will perform pre-registration and registration tasks to create medical records and bills, gathering essential demographic, visit, and financial details. Insurance benefits are confirmed through online systems and phone inquiries, ensuring accurate billing and compliance.
A significant part of the role involves cash collection.The representative is responsible for notifying patients of any self-pay liabilities before their scheduled procedures. According to Sharp HealthCare,if a patient cannot pay the full amount,the representative should negotiate a partial payment. They must also request payment for co-pays, deductibles, or coinsurance before services are rendered. All funds received must be properly documented with receipts and updated in the Centricity system to ensure accurate auditing.
Notification to scheduled patients with any self-pay liability at least 1 day prior to procedure. If patient is unable to pay requested amount, negotiate a portion.
The representative must also ensure the security of all funds and receipts at all times and prepare ancillary deposits according to department and hospital standards. Competent use of the self-pay price quote system is essential.
Completing insurance verification and obtaining necessary authorizations are critical components of this role. The representative must review all scheduled patient accounts to ensure pre-verification before procedures. Using centricity Business Visit Manager, they review pre-scheduled radiology procedures and complete the Visit Manager checklist as needed.Insurance coverage information is reviewed in Centricity Business, and standard Coordination of Benefits standards are applied to prioritize billing order for insurance plans.
The representative also reviews insurance eligibility and benefits in MPV and verifies that all required hard copy authorizations are scanned into the system. They identify co-pay amounts and any other patient liabilities, including coinsurance and deductible amounts, updating Centricity visit comments with expected patient out-of-pocket expenses. Compliance with Medicare and Medi-Cal billing regulations is mandatory, ensuring all billing compliance standards are met. The role also involves reviewing and addressing hold bills as appropriate.
Review all scheduled patient accounts to ensure pre-verification prior to the procedure.
Department Operations and Patient Interaction
The Patient Access Services representative is responsible for answering incoming ancillary phone lines respectfully and efficiently. They must handle call volume effectively and transfer calls accordingly. The ability to review ancillary computer systems to assist with monitoring patient flow and wait times is crucial. Patients and their families must be informed of any delays, including the reason for the delay. The representative monitors the ancillary waiting area and provides updates to patients as needed.
Teamwork and cooperation with the ancillary area are essential, fostering positive communication. Downtime should be used productively, and the representative must prioritize tasks effectively, keeping management informed of any backlogs.
Answers incoming ancillary phone lines in a respectful manner.
Patient Data Management and safety
Managing patient data accurately is a core obligation. The representative populates all demographic screens for new and established patients to comply with Sharp Registration Standards. They secure patient signatures on address attestations and deliver the Notice of Privacy Practices (NPP) and Patient Rights to new patients, updating the registration field related to NPP. Obtaining accident-related information and entering appropriate diagnoses without abbreviations are also required. Securing Primary Care Provider information is another key task.
Patient safety is paramount. The representative coordinates the check-in of all scheduled and non-scheduled patients to the ancillary area to ensure patient safety. They authenticate and/or enroll patients in Patient Secure palm scanning, following established guidelines such as scripting and picture identification for enrollment/authentication.In the absence of patient Secure, at least two patient identifiers must be used to confirm patient identity. Reviewing physician orders to facilitate check-in and appropriately prioritizing scheduled patients are also essential. The representative must notify DUPREG when potential duplicate registrations are identified.
Coordinate check-in of all scheduled and non-scheduled patients to the ancillary area to ensure patient safety.
Regulatory Compliance and OnBase Utilization
The representative must review Conditions of Admission (COA) with patients using scripting, secure signatures on the COA, and update the COA field. For Medicare patients, completing the Medicare Secondary Payer (MSP) questionnaire is required. The representative utilizes OnBase to review physician orders and obtain and scan all necessary access service-related documents, such as physician orders, hard copy authorizations, ID cards, and insurance cards. All scans must be clear and associated with the correct identifier and account.
Required Skills and Abilities
The ideal candidate will possess the ability to communicate and discuss personal and financial matters with patients and their representatives effectively. Strong documentation skills, both concise and effective, are essential. The ability to communicate effectively both verbally and in writing is crucial,as is the ability to function well in demanding and stressful environments.
Unveiling the Crucial Role of Patient Access Services Representatives: An In-Depth Interview
“The healthcare revenue cycle hinges on the efficiency and accuracy of patient access services. A single misstep can create a ripple effect, impacting patient care and financial stability.”
Interviewer (Senior Editor, world-today-news.com): Dr. Anya Sharma, welcome. Your expertise in healthcare administration and revenue cycle management is invaluable. The job posting for a Patient Access Services (PAS) Representative at Sharp HealthCare highlights a critical yet often overlooked role. Can you elaborate on the significance of this position within a larger healthcare system?
Dr.Sharma: Absolutely. The Patient Access Services Representative is the often-unsung hero of the healthcare revenue cycle. Their responsibilities, as highlighted in the Sharp HealthCare posting, are multifaceted and crucial for smooth operations. They act as the first point of contact for many patients, setting the tone for their overall healthcare experience. Efficient patient registration, accurate insurance verification, and timely financial processing directly impact the bottom line and the quality of patient care. A well-trained PAS Representative prevents delays, streamlines billing, and ensures compliance with regulations.
Interviewer: The job description emphasizes pre-registration,insurance verification,and cash collection. Can you break down these key responsibilities and explain how they contribute to a successful revenue cycle?
Dr. Sharma: These are indeed core functions. Pre-registration involves collecting patient demographic and insurance facts before the appointment, minimizing wait times and ensuring a smoother check-in process. Insurance verification is critical; it confirms coverage, benefits, and any pre-authorization requirements, preventing claim denials down the line. Cash collection involves managing patient payments, including co-pays, deductibles, and coinsurance. Efficient processes in these areas minimize accounts receivable and contribute to improved financial performance. Think of it as a well-oiled machine: each part – pre-registration, verification, and collection – must work seamlessly.
Interviewer: The role also mentions the importance of using specific systems like Centricity and OnBase. How crucial are Electronic Health Record (EHR) systems and other technologies in modern PAS operations?
Dr. Sharma: absolutely integral. EHR systems like Centricity are the backbone of modern patient access services. They centralize patient information, streamline workflows, and reduce manual errors. OnBase, a document management system, enhances efficiency by allowing for secure storage and retrieval of crucial documents, reducing the reliance on paper-based processes. Utilizing these systems not only improves efficiency but also ensures compliance with HIPAA regulations concerning patient data security and privacy. Investing in the right technology is crucial for modern healthcare providers seeking to optimize their revenue cycle.
Interviewer: Patient safety is also mentioned. Can you provide examples of how a PAS Representative contributes to a safe patient experience?
Dr. Sharma: Patient safety is paramount. The PAS Representative plays a crucial role in verifying patient identity through processes such as patient secure palm scanning or dual identification methods. This prevents medical errors by ensuring that services are provided to the correct patient. Accurate and complete patient data collection, including accident details and primary care physician information, enhances coordinated care and is crucial for ongoing treatment. Furthermore, effectively managing patient flow in the waiting area contributes to a less stressful and more secure patient experience.
Interviewer: The posting highlights the need for strong interaction and interpersonal skills. why are soft skills so vital in this role?
Dr. Sharma: In this role, you’re not just dealing with numbers and systems; you’re interacting with patients who might potentially be anxious, in pain, or facing financial challenges. A good PAS Representative needs to be empathetic, patient, and a skilled communicator able to clearly explain complex insurance policies and financial responsibilities in a way that fosters understanding and cooperation. Successfully navigating possibly challenging conversations requires delicate handling and excellent interpersonal skills. These soft skills are just as vital as the technical skills.
Interviewer: So,what are the key takeaways for someone considering this career path?
Dr. Sharma: Here is a short list for aspiring PAS Representatives:
Strong organizational and attention-to-detail skills are paramount. A single error can have significant repercussions.
Technological proficiency is essential. Familiarity with EHR systems and other healthcare-related software is crucial for success.
Excellent communication and interpersonal skills are vital. This role involves frequent interaction with patients and other healthcare professionals.
Knowledge of insurance and billing procedures is beneficial. While not always required upfront, it certainly provides an advantage.
* Professional certifications, such as HFMA, are highly valued. These credentials demonstrate commitment to the profession and expertise within the revenue cycle.
Interviewer: Thank you, Dr. Sharma, for your insightful contributions. This has painted a thorough picture of the value and complexities of the Patient Access Services Representative role.
Final Thought: The Patient Access Services Representative role is foundational to the smooth functioning of any healthcare system. Their dedication to accurate patient registration, insurance verification, and financial processing, coupled with their commitment to patient safety and empathy, ensure efficient operations and contribute to a positive overall patient experience. Share your thoughts on the importance of this frequently enough-unsung role in healthcare in the comments below!