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Patient Access Associate NJS Eligible PD

Job ID: 139914
Category: Customer Service/Patient Access
Work Type: PER DIEM
Location: Plainsboro, NJ, United States
Date Posted: Jun 27, 2022
Work Schedule: variable

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Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Summary:

  • Under general supervision, the Patient Access Associate is responsible for computerized patient registration including obtainment and verification of all required demographic and insurance information to ensure accurate and timely reimbursement. Collect time of service payments.

Responsibilities:

  • Greets patient with a positive and professional attitude and initiates registration process. Selects the correct patient through properly entering the required fields within the ADT system to ensure patient safety and creates visits appropriately in the ADT system.
  • Performs follow up on assigned third party accounts for all in-house admissions and select outpatients (e.g. PAT, Radiation Oncology). Follow up includes but is not limited to verifying eligibility, obtaining benefits, ensuring pre-certification and/or authorization/referral requirements have been completed.
  • Demonstrates flexibility and adaptability to changing work environment. Demonstrates willingness to meet the needs of departmental operations effectively as an individual and Team Member
  • Support Customer Service and Performance Improvement goals of the Department.
  • Determines and appropriately documents out of pocket responsibility for services as related to insurance contracts or PHCS Fee Schedules (i.e. Self Pay Fee Schedule, Cosmetic Surgery List). Collects Time of Service (TOS) and Point of Service (POS) Payments according to policy. If necessary refers patient to Financial Counselor for assistance.
  • Participates in educational sessions, seminars, staff meetings and Hospital sessions, utilizing the information provided to enhance patient care activities and work behaviors.
  • All Patient Access Associates assigned bedside registration (ED and Surgical Areas) are required to utilize Workstation On Wheels (WOW).
  • Patient Access Services Responsibility
  • Insurance Verification
  • Performs follow up on assigned third party accounts for all in-house admissions and select outpatients (e.g. PAT, Radiation Oncology). Follow up includes but is not limited to verifying eligibility, obtaining benefits, ensuring pre-certification and/or authorization/referral requirements have been completed.
  • Utilizes web based applications and or internet resources to follow up on outstanding items. Contacts insurance companies, physician offices, and patients as needed to facilitate coverage and payment within established guidelines.
  • Processes correspondence from insurance companies, case management and other areas within 24 hrs of receipt.
  • Utilizes web based applications and or internet resources to follow up on outstanding items. Contacts insurance companies, physician offices, and patients as needed to facilitate coverage and payment within established guidelines.
  • Processes correspondence from insurance companies, case management and other areas within 24 hrs of receipt.
  • Navigator Functions
  • Greets patient with a positive and professional attitude and initiates registration and/or check-in process depending on situation.
  • Reviews physicians’ orders and front desk schedules to determine process flow and instruct patients accordingly.
  • Appropriately places patient on the correct Clinical System wait list.
  • Responsible for answering the department Navigator phone and processing requests such as patient registration inquiries as needed.
  • Ensures that the appropriate signatures are obtained to meet regulatory requirements. Scans all appropriate paperwork on correct visit.
  • Outpatient Registration (Includes Main, ED and Endoscopy Unit)
  • Interviews patient/family in a caring, empathetic, and professional manner for purpose of obtaining demographic and insurance information for appropriate billing and ensures that the appropriate signatures are obtained to meet regulatory requirements.
  • Contacts physicians’ offices, insurance companies, patients and/or hospital clinical departments when necessary to obtain any missing information.
  • Determines and appropriately documents out of pocket responsibility for services as related to insurance contracts or PHCS Fee Schedules (i.e. Self Pay Fee Schedule, Cosmetic Surgery List). Collects Time of Service (TOS) and Point of Service (POS) Payments according to policy. If necessary refers patient to Financial Counselor for assistance.
  • Accurately assigns and enters ICD codes into the ADT system as appropriate with 95% accuracy.
  • Ensures that the appropriate signatures are obtained to meet regulatory requirements. Scans all appropriate paperwork on correct visit.
  • Inpatient and Bedded Outpatient Admission
  • Identifies admission, transfer, conversion, and upgrade requests by monitoring the Emergency Department Registration Track and Clinical System Transfer Queue and responds to requests within ten minutes to facilitate timely bed assignment.
  • Converts patient services as per department protocol.
  • Coordinates admissions as appropriate with physicians’ offices and nursing supervisor as needed. Documents bed assignment within appropriate system(s).
  • Completes Notice of Admission for associated payers through appropriate notification mechanisms.
  • Reviews Operating Room scheduled daily for any additions and/or canceled admissions.
  • Ensures that the appropriate signatures are obtained to meet regulatory requirements. Scans all appropriate paperwork on correct visit.
  • Daily Operations
  • Insurance Verification
  • Reviews Daily Census and Inpatient Verification Report to ensure Notice of Admission for associated payers through appropriate notification mechanisms has been completed. Completes Notice of Admission as needed.
  • Obtains additional information from in-house patient/family as needed to expedite payment.
  • Communicates with Care Coordination when carrier requests clinical information before authorizing visit and as needed for appropriate service conversions.
  • Refers patients to Financial Counselor as needed.
  • Acts as back-up to Navigator. Also supports Outpatient, Inpatient and Bedded Outpatient Admission Area.
  • Opens Hospital Information Systems and appropriate IT technology at the start of assigned shift and keep them open during the shiftt and utilizes single sign on for appropriate applications.
  • Escalates interdepartmental communication for immediate resolution of potential customer service and patient relations problems. Notifies the Patient Access Supervisor or Manager or Clinical Department Management as needed.
  • Navigator Functions
  • Communicates clearly with the patient in regards to process flow
  • Maintains department benchmark for wait times through prioritizing patient registration according to established procedures
  • Acts as back-up to the Outpatient Registration Area
  • Opens Hospital Information Systems and appropriate IT technology every morning and keep them open during the day and utilizes single sign on for appropriate applications.
  • Escalates interdepartmental communication for immediate resolution of potential customer service and patient relations problems. Notifies the Patient Access Supervisor or Manager or Clinical Department Management as needed.
  • Outpatient Registration (Includes Main Registration and Endoscopy Unit)
  • Communicates clearly with the patient in regards to process flow
  • Acts as back-up to the Navigator. Also supports Inpatient and Bedded Outpatient Admission Area.
  • Maintains department benchmark for wait times through prioritizing patient registration according to established procedures. Registers all scheduled patients within 5 minutes of patient’s entry into the registration area and all unscheduled patients within 10 minutes of arrival.
  • Utilizes on-line verification system or place phone call to insurance company to ensure that all necessary referrals, authorizations and pre-certifications are in place.
  • Opens Hospital Information Systems and appropriate IT technology st the start of the assigned shift and keep them open during the shift and utilizes single sign on for appropriate applications.
  • Acts as back-up to the Emergency Department and Inpatient and Bedded Outpatient Admission Area.
  • Escalates interdepartmental communication for immediate resolution of potential customer service and patient relations problems. Notifies the Patient Access Supervisor or Manager or Clinical Department Management as needed.
  • Outpatient Registration (ED)
  • Communicates clearly with the patient in regards to process flow.
  • Prioritizes cardiac, psychiatric and stroke patient registration according to established procedure. Registers all patients within 20 minutes or less of patient triage.
  • Monitors Emergency Department Queue and completes registration of patients following established protocol for order of processing.
  • Escalates interdepartmental communication for immediate resolution of potential customer service and patient relations problems. Notifies the Patient Access Supervisor, Manager or Emergency Department Director as needed.
  • Opens Hospital Information Systems and appropriate IT technology at the start of the assigned shift and keep them open during the shift and utilizes single sign on for appropriate applications.
  • Acts as back-up to the Inpatient and Bedded Outpatient Admission Area.
  • Inpatient and Bedded Outpatient Admission
  • Communicates clearly with the patient in regards to process flow.
  • Attends daily Bed Board Meetings and any specially requested bed meetings.
  • Acts as back-up to the Navigator. Also supports Main Registration.
  • Escorts or arranges to have patient escorted to procedure areas.
  • During levels above Routine, identifies patients with no bed and works in conjunction with Nursing Supervisor to place patients in the appropriate location.
  • Escalates interdepartmental communication for immediate resolution of potential customer service and patient relations problems. Notifies the Patient Access Supervisor or Manager or Clinical Department Management as needed.
  • Opens Hospital Information Systems and appropriate IT technology at the start of the assigned shift and keep them open during the shift and utilizes single sign on for appropriate applications.
  • Core Values
  • Take initiative to resolve accounts with and without supervision. Works toward department goals and visions as an individual and Team Member.
  • Maintains confidentiality of patient information in accordance with Princeton HealthCare System Policies.
  • Understands how applicable laws, regulations, polices and procedures impact specific job responsibilities and functions. Demonstrates actions to reasonable prevent, detect and report unethical and unlawful business practice.
  • Familiarity with the general usage and spelling for specific medical terminology.
  • Revenue Cycle Development
  • Promote Teamwork both internally and externally across all department lines
  • Works in collaboration with other departmental associates as well as other hospital associates supporting their efforts though teamwork and the acceptance of additional assignments.
  • Accepts responsibility for own actions, while taking ownership of departmental outcomes.
  • Maintains a strong working relationship with physicians and Departments that the Patient Access Services Team services including Emergency Department, Surgery Team, Nursing Unit Manager, Ancillary Service Departments, Patient Financial Services, Health Information Management and Information Services to ensure maximum communication and coordination of service.
  • Performance Improvement
  • Collaborate with other staff, within and outside the Department, to develop means of enhancing patient care and service.
  • Demonstrates a concern for cost containment for the organization and its customers.
  • Educational Development
  • Maintains working knowledge of insurance plan codes, third party billing requirements and insurance coverage by reading updates and other provided documentation.
  • Ability to learn, develop and apply new concepts. Demonstrates interest in further skills development such as cross training.
  • Seeks guidance and advice in solving problems beyond own experience and/or knowledge.
  • Participates in Unit Compliance as related to Established Standards.
  • Performs all other duties as assigned

Credentials:

    Education or Equivalent Experience:

    • H.S. Diploma/GED (Required)
    • High school diploma or equivalent Two years of medical experience, with previous hospital or physician office registration experience preferred.

    We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

    Live Your Life's Work

    We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

       Current UPHS employees must apply HERE
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