Patient Access Representative Senior - Admitting at CHRISTUS Santa Rosa Health System

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Summary:

Pre-Arrival Associates initiate the very first contact with our patients and must strive to extend a warm welcoming encounter to all patients and/or family choosing CHRISTUS Santa Rosa to provide their care. Pre-Arrival Associates ensure that all data entry is accurate including demographic and financial information for each account. Pre-Arrival Associates have numerous procedural requirements including data elements, insurance verification, authorization for services, and collections for all patient portions including prior balances. Pre-Arrival Associates are responsible for the successful financial outcome of all patient services. Pre-Arrival Associates are responsible for ensuring the hospital maintains compliance with Federal regulations, JCAHO, and Department of Health and Hospital compliance standards. Pre-Arrival Associates communicate directly with patients and families, physicians, nurses, insurance companies, third party payers and all internal customers. This position requires professional appearance, and behavior, excellent communication and effective organizational skills. Pre-Arrival Associates require dependability, flexibility, and teamwork.

The members of the Pre-Arrival Team support every facility in the Santa Rosa Region. They work directly for the facility-based Patient Access Teams and physician groups, preparing the CHRISTUS Santa Rosa patient population to arrive for a seamless patient experience. These roles are designed to promote the demonstrated knowledge and competency of Pre-Arrival duties across all areas, including a demonstrated ability to use good judgment in making independent decisions when employing Service Recovery to resolve customer issues in all routine operations. This team also includes Financial Clearance Representatives skilled in driving Charity Applications and Pre-Arrival Collections. In addition to these roles, the Pre-Arrival Team also has a specialized Authorization Procurement Team that initiates and maintains collaborative, professional relationships with all physician offices and clinics that care for the Santa Rosa patient populations. Order Indexing also resides within this team. Our indexing team also employs a constant collaborative relationship with physicians and facilities to ensure only current, valid orders are housed in our Central Order Repository by employing daily communication with both providers to optimize the availability of the complete order in advance of the patient appointment. Centralized Scheduling is housed within the Pre-Arrival Team as well. They are available to physician offices and patients to precisely schedule one or multiple visits/patients in any facility in the region while correctly delivering patient instructions. 

CHRISTUS Santa Rosa Hospital - New Braunfels (CSRH-NB), nestled in the heart of downtown New Braunfels, is a full-service, 94-private bed facility that continues to expand to meet the needs of New Braunfels’ strong population growth. Innovative equipment and procedures are utilized, including an Outpatient Imaging Center, orthopedic and surgical services, rehabilitation, a renovated birthing center, including 24/7 neonatal coverage, emergency care, wound care/hyperbaric center, 3D mammography, and comprehensive heart care, from diagnostics to open-heart surgery. 

Responsibilities:

• Accurately inputs all required data elements for scheduling and registration, including patient demographic, financial information, guarantor information, and relevant notes associated with the interaction.
• Verifies insurance eligibility and obtains necessary authorizations for services rendered in advance of the date of service.
• Calculates and attempts collection on any estimated patient portion based on benefits and contract reimbursement as well as prior balances.
• Performs financial assessment and charity determination for appropriate program assistance.
• Represents the Pre-Arrival department in a professional, courteous manner at ALL times.
• Available to assist the hospital in the event of an internal or external disaster.
• Supports the flexible needs of the department to accommodate patient volume in all areas of the Pre-Arrival Team (cross-training). This may require assignment to another area of the department and/or shift change.
• Serves as a point of primary contact for patient/physician/customer concerns/issues.
• Supports the department in achieving established performance targets.
• Completes required training as needed and as mandated.
• Maintains the team discipline of following all elements of established standard processes
• Continually supports best practices and process improvements to insure high quality deliverance of all Pre-Arrival Services.
• Coordinates, communicates, and assists in monitoring work flow and work tasks necessary to manage fluctuating volumes and service standard norms.
• Provides feedback to the team to help identify educational needs, and mediation needs by reporting IPOs (issues, problems, and opportunities).
• Demonstrates competence to perform assigned responsibilities is a manner that meets the population-specific and developmental needs of the members served by the department.
• Appropriately adapts assigned assessment, treatment, and/or service methods to accommodate the unique physical, psychosocial, cultural, age-specific and other developmental needs of each member served.
• Takes personal responsibility to ensure compliance with all policies, procedures and standards as promulgated by state and federal agencies, the hospital, and other regulatory entities.
• Performs all duties in a manner that protects the confidentiality of patients and does not solicit or disclose any confidential information unless it is necessary in the performance of assigned job duties.
• Demonstrates adherence to the CORE values of Santa Rosa Health Care.
• Performs other duties as assigned. 

Requirements:

Education 

• High school diploma or equivalent required. 
• Bi-lingual Spanish is a plus.

Education

• A minimum of one year experience in any Patient Access, scheduling, authorization procurement, pre-registration, medical office, billing/collection function, or a comparable customer service related position preferred.
• Previous call-center environment a plus. 3. Experience is preferred, but, we are welcoming of candidates with an outstanding attitude and eagerness to learn a new skill.

Licenses, Registrations, or Certifications

• Certified Healthcare Access Associate (CHAA) through National Association of Healthcare Management (NAHAM) is preferred. The Pre-Arrival Team Leadership has mandated this to be completed preferably within the first 6 months of employment and no later than the associates’ first anniversary. Continued employment at a PAR II level hinges on passing this certification within the stated timeframe and the bi-annual maintenance of that certification. 

Work Type:

Full Time

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