Part-Time Access Representative - Westwood Campus 1/17/2020
University of California - Los Angeles Medical Centers
Los Angeles, CA
JOB DESCRIPTIONAPPLY Responsibilities
Under the general guidance of the Access Manager, the Patient Access Coordinator A pre-registers, pre-admits, and admits patients by telephone and/or in person. Major duties include: collection of accurate demographic information, review and interpretation of insurance benefits, obtaining prior authorizations, cash collections, interaction with public assistance programs (i.e. Medi-Cal, CCS), implementation of Medicare requirements, interaction with physicians/office personnel as well as other hospital personnel (i.e., SDA, OPSU, nursing units), and referral of appropriate cases to other internal and external sources to assist patients with discharge/post-hospital care. Interact with hospital departments such as Utilization Review and Patient Business Services to ensure correct and timely reimbursement. General supervision and direction is provided by the Access Manager, through regular divisional meetings, departmental meetings and continual communication. Prioritize and complete standard functions following established departmental guidelines and University policies. The Access Manager reviews work when there is a deviation from standard guidelines
1. Assign patient medical record number to all new patients. Search, review, and identify assigned patient s medical record number.
2. Admit / register departmental-private and personal-private patients for inpatient / outpatient services. This includes elective, scheduled, unscheduled and emergency patients.
3. Explains in detail, admissions / registration procedures and necessary information to patients or responsible party.
4. Accurately identify third-party sponsorship codes.
5. Accurately completes OSHPD requirements.
6. Accurately enters demographic/financial information utilizing proper ADT functions.
7. Apply correct financial class code with accuracy.
8. Obtain appropriate signatures on admission / registration documents.
9. Consistently meets JACHO requirements by completing Advance directive, COA and patient rights.
10. Enter admission/registration information appropriate sponsorship code into ADT to generate admission / registration documents and identification cards.
11. Identify patient s room assignment on all admissions. Validate personal Attending(s) on all patient referrals with patient or family unit as appropriate.
12. Referring physician is consistently and accurately identified.
13. Imprint, separate, and review all admission / registration forms; prepare billing folders and distribute appropriate documents to various departments.
14. Demonstrates appropriate folder note documentation that is grammatically correct and concise.
15. Maintain current knowledge of Medi-Cal Treatment Authorization Requests (TARs); be able to interpret completed, approved, denied, and deferred TAR s.
16. Determine priority of payors based on benefits, work status, age, and birth date of subscriber. Understand and comply with Medicare Secondary Payor (MSP) regulations.
17. Initiate referrals to other entities based on identified needs, i.e., pastoral care, continuity of care, Social Services, to assist patients with financial, social and religious needs.
B. Reimbursement Knowledge
1. Accurately determines priority of payers based on State, Federal and private insurance regulations.
2. Demonstrates knowledge in understanding of MSP regulations
3. Performs basic insurance eligibility functions for State, Federal and private payers.
4. Demonstrates ability to perform DDE functions and interpret data
5. Demonstrates the ability to interpret Treatment Authorization Request (TAR) and accurately performs AEVS.
C. Payment Determination/Cash Collection
1. Determine charges / deposits for specific services / procedures using the Hospital and Clinics Rate Manual and / or established deposits chart. (SMH Only)
2. Collects cash, credit cards and check payments as per department protocols following established university guidelines.
3. Act as liaison between patient, Patient Access Financial Services and Patient Business Services to ensure appropriate payment on admission.
4. Refer patients to appropriate resource when questions regarding billing.
D. Other Duties
1. Accurately collect and release patient valuables as per department protocols following established university guidelines.
2. Compile and address patient information packets as needed.
3. File insurance information, after determining completeness / accuracy in patients folders.
4. Maintain a current reference directory of commonly called agencies, physicians office personnel to assist with day-to-day functions.
5. Maintain and up-to-date handbook with pertinent department and hospital memos to assist with day-to-day functions.
6. Provide backup admission/registration assistance in other areas and all other duties as assigned.
E. Communication Work Skills
1. Demonstrates effective oral communication skills a timely manner with department and interdepartmental team members.
2. Keeps manager well informed of status of projects, problems and action plans which affect personal and department performance.
3. Actively participate in departmental staff meetings for the exchange of information.
4. Maintain current patient identification and notify appropriate areas of all name changes / temporary names.
F. Team Play/Guest Relations/Interpersonal Skills/Work Habits
1. Demonstrates teamwork by working effectively with others toward common goals.
2. Assist in training of newly hired staff members.
3. Responds to interdepartmental requests timely and accurately.
4. Contributes to the overall satisfaction of patients, physicians and other third party parties.
5. Demonstrates a high level of mental and emotional tolerance and even temperament in interacting with people, uses tact, sensitivity and sound judgment at all times.
6. Demonstrate confidentiality procedures with verbal, written and electronic data.
7. Maintains standard of attendance and punctuality.
UCLA is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.