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Patient Access Representative II

Job Description


Job ID: 1206103
Employment Status: Full-Time
More Information:

BJC Home Care Services offers patients and their families a complete range of home care services, including skilled nursing services, adult and pediatric hospice and supportive care, rehabilitation therapy, home infusion therapy, infusion treatment rooms, home medical equipment and high-tech respiratory care. Specialty home care programs also are available, including adult and pediatric asthma, cardiac, diabetes, orthopedic and wound care programs as well as the Lifeline emergency response system. BJC Home Care Services provides care to thousands of patients in both Missouri and Illinois. Serving more than 25 counties, it has become the largest home care network in the region and one of the largest in the country.

The Central Referral Center (CRC) for BJC Home Care Services is where the patient referral process starts. There are Intake Coordinators in each BJC hospital who coordinate services for those patients that need home care. The patients who choose BJC Home Care Services are then channeled through the CRC. The CRC also consists of nurses who take physician office referrals for patients not currently hospitalized. There is someone on-call 24/7 for the CRC to facilitate home care coordination for patients in emergency rooms, etc.


Overview


Role Purpose

The Patient Access Representative is often the first point of contact for our patients and therefore must represent BJC with the highest standard of customer service, compassion and perform all duties in a manner consistent with our mission, vision, values, and BJC service standards. The Patient Access Representative will facilitate all components of the patients' entrance into any BJC facility. This position will require a high level of emotional intelligence and making a personal connection. The patient experiences vary broadly based on their medical needs and acuity. This position highly impacts the ability to maximize the level of reimbursements and prevention of denials by accurate collection of demographics and insurance information, benefit verification and point of service collection. Selecting the correct patient from the master person index (MPI) is critical to patient safety. This team member must possess a friendly demeanor, exceptional attention to detail and maintain knowledge and competence with insurance carriers, Medicare guidelines as well as federal, state, and accreditation agencies.


Responsibilities

  • The responsibilities of this position include hospital registration and scheduling within multiple BJC systems. Assures proper patient identification, registers, schedules, verifies insurance, scans and retrieves documents within multiple BJC systems. Validates that the order is complete, signed by the ordering provider, and the correct test is ordered. The attention to detail is essential to ensure accurate patient records.
    Strong communication skills are necessary in order to provide the patient with preparation instructions for each scheduled procedure, education on financial responsibilities and collection of applicable patient payments.
  • In order to comply with complex regulatory guidelines, must be able to understand, articulate and enforce hospital compliance with Medicare Secondary Payer (MSP), HIPAA Privacy Standards, Patient Bill of Rights and Responsibilities, Advance Directives, Consent to Treat, EMTALA, JCAHO Requirements. Each patient completes HIPAA acknowledgement. This position requires a higher level of independent thinking in order to solve complex issues.
  • Utilize critical thinking skills to assess and respond to a variety of situations, anticipating patients' needs and being able to respond to them.
    Communicate in a professional, positive, and patient-focused manner with all patients, families, and co-workers whether in-person or by phone. This responsibility is critical to ensure positive patient experience, maximize reimbursements, and minimize denials and avoidable write-offs, and ensuring that we are maintaining the integrity of the patients clinical and financial record by correctly selecting the correct from our MPI Working independently, this team member will consistently meet or exceed quality standards and serve as mentor for lesser skilled employees.
  • BJC has determined this is a safety-sensitive position. The ability to work in a constant state of alertness and in a safe manner is an essential function of this job.

  • Minimum Requirements

     

    Degree

  • High School Diploma or GED
  •  

    Experience

  • <2 years

  •  

    Preferred Requirements and Additional Job Information

     

    Degree

  • Associate's Degree
  •  

    Experience

  • 2-5 years
  •  

    Supervisor Experience

  • No Experience
  •  

    Licenses & Certifications

  • CHAA

  • Benefits Statement

    Note: not all benefits apply to all openings

    -  Comprehensive medical, dental, life insurance, and disability plan options
    -  Pension Plan*/403(b) Plan
    -  401(k) plan
    -  Tuition Assistance
    -  Health Care and Dependent Care Reimbursement Accounts
    -  On-Site Fitness Center (depending on location)
    -  Paid Time Off Program for vacation, holiday and sick time

    *Pension does not apply to Memorial Hospital, Memorial Hospital East, Alton Memorial or Parkland Health Center


    Legal Statement

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.

     

    Equal Opportunity Employer