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Vail Health · 5 days ago

Patient Access & HIM Representative Surgery Center

Basalt, Colorado, United States

Full-time

Onsite

New Grad, Entry Level

$21.32/hr - $25.70/hr

Vail Health has become the world’s most advanced mountain healthcare system, providing exceptional care in a state-of-the-art facility. The Patient Access & HIM Representative is responsible for patient registration, admissions, and insurance-related tasks, as well as the assembly and maintenance of medical records.

Health CareHospitalMedicalNon ProfitOncologyTherapeuticsWellness

Responsibilities

Registers patients and performs all registration-related functions, including explaining and obtaining all necessary patient consents and authorizations in a complete and timely manner, and collecting financial paperwork (e.g., patient responsibility statement, etc.) and co-payment as required

Communicates effectively with patient to assist in access to care by: answering telephone and other incoming communications in a timely and customer-service oriented manner; replying to inquiries, patient needs for information, and other parties clearly and in a timely manner; and, if information is not readily available, follows up with inquiries to responsible party

Resolves all non-clinical questions within scope of knowledge while providing excellent customer service on the phone and/or in person

Performs on-going documentation audits for medical necessity, plan of care, and other related tasks or requirements by payors, including Medicare, using a variety of computer-based systems

If in a procedure-based department, routinely schedules appointments for all procedures educating each patient with pre-exam and if necessary, post-exam requirements within scope. Organizes, generates and distributes patient reminders, results, and recall letters

Manages, directs and responds to incoming office correspondence as deemed appropriate, including mail, email, faxes, and telephone calls and forward queries to the appropriate staff

Organizes, monitors, and orders front desk supply inventory to assure cost effective departmental spending

Follow the Center for Medicare & Medicare Services (CMS) requirements for checking medical necessity communicates relevant coverage/eligibility information to the patient. Identifies patients who will need Medicare Advance Beneficiary Notices (ABNs) of non-coverage and maintains accurate records of authorizations within the EMR

Completes Medicare Secondary Payer Questionnaire for Medicare beneficiaries in accordance with Centers for Medicare & Medicaid Services (CMS) standards

Accurately maintains the predetermined, organized and secured record format. Arranges the scanning of medical records and verifies completeness

Required to inform physicians of signed documentation delinquency according to policy and procedures

Communicates nursing documentation deficiencies to clinical management

Receives and logs requests for medical information and obtains appropriate releases before filling medical record requests

Assists management with month-end closing procedures. Prepares and/or reviews various month end reports

Assists the clinical staff with the collection and coordination of data such as blood usage, surgery complications, etc. that are included in the medical record review process

Receives requests for records to be reviewed by external auditors, compiles copies and/or sets up queue for these encounters to be reviewed. Validates that no restrictions apply to the encounters requested. Keeps Director informed of the status of project preparation. Mails or sends the copies in accordance with the requestor’s instructions

Role Models the Principals of a Just Culture and Organizational Values

Ensures compliance with all applicable HIPAA, EMTLA and Joint commission requirements, providing required associated literature to patients

Performs other duties as assigned on department and organizational-level. Must be HIPAA compliant

Qualification

Patient registrationMedical records managementCustomer serviceComputer skillsEnglish language proficiency

Required

Customer service and clerical experience

Must possess, or be able to obtain within 90 days, the computer skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc

Must have working knowledge of the English language, including reading, writing, and speaking English