Riverside Health Care
Job Description The Scheduling Patient Access Associate II must be competent in the following: registering, scheduling, insurance\/Medicare\/Medicaid compliance and strong customer service skills. The Patient Access Associate II must have the ability to work independently in a fast-paced environment. Interacting in a customer-focused and compassionate manner to ensure patients and their representatives' needs are met, and that they understand the hospital's revenue cycle expectations, including resolution through various payment options. The Patient Access Associate II will accurately collect, analyze and record demographic, insurance\/financial and clinical data from multiple sources, and obtain other information and signatures necessary for registration and billing. Effectively screens for compliance with payer requirements for medical necessity and precertification and complete third-party eligibility and benefit verification to ensure accurate payment is secured. Responsibilities PART III: POSITION RESPONSIBILITIES (ESSENTIAL FUNCTIONS) Accurately collects and analyzes all required demographic, insurance\/financial, and clinical data necessary to schedule, pre-register, and register patients from all payor classes. Electronically records information on a timely basis. Follows EMTALA, HIPAA, payor and other applicable regulations and standards for registration. Reviews previously recorded information and analyzes active patient records to identify and resolve situations where care is different than originally identified, including reverification of payor information and medical necessity, revising and information all affected parties. Assesses work flow and prioritizes departmental needs in relationship to own to ensure there is timely response to incoming calls and outstanding orders. Reviews call software consistently and makes necessary staffing adjustments to meet volumes. Attends all mandatory continuing education and department meetings. Reviews email timely to keep abreast of current information. Coordinates scheduled appointments effectively with regard to clinical urgency, procedural conflicts, physician and patient preference. Provides accurate and thorough documentation. Optimizes patient schedules for convenience and continuum of care. Routinely preregisters appointments at time of scheduling whenever possible to ensure patient satisfaction and prompt the benefit process. Knowledgeable of all available resources and uses them effectively and independently. Maintains and organizes own reference materials, both financial and clinical. Provides clear and complete preparation instructions for tests\/procedures, and appropriately guides to applicable treatment site. Provides greeting to help customer determine appropriate location and process to occur. Identifies self to all patients and their representatives and takes ownership of service encounter through completion, keeping patient and family informed of process and any delays. Listens and communicates effectively and compassionately with customers, ensures understanding and explores options. Receives, properly responds to, or redirects telephone, electronic and in-person inquiries from patients, their representatives, payers, physicians and their staff, internal departments, and other entities. Accurately sorts and distributes incoming faxes and mail. Maintains confidentiality of personal health information working within the minimum necessary guidelines. Reviews physician orders and other documentation against payer coverage and medical necessity criteria, uses screening software to determine whether services being provided meet third-party requirements for payment, contacts physicians as necessary for additional clinical information; informs physicians about payer requirements, initiates Medicare ABN processes as appropriate. Explains payer policies to patients and financial responsibility within the revenue cycle to assist in meeting other internal, regulatory and payor requirements. Documents financial expectations of payer and medical necessity verification. Refers appropriately to Patient Financial Services. Qualifications Experience\/Education Requirements: High School Diploma or equivalent. Computer literacy. Medical Terminology preferred. Office or other clerical experience preferred. Ability to read and write in English. Verbal skills required to interact on the telephone or in person in a courteous and respectful manner. Ability to do general arithmetic. Prior Call Center experience preferred. Prior knowledge of payer regulatory compliance and HIPAA Privacy and Security requirements. Detail oriented, committed to accuracy, and ability to problem solve. Understanding of the hospital revenue cycle. License or Certification Requirements: None
Riverside Health Care
Website : http://www.riversidehealth.org/
St. John's Riverside Hospital opened its doors as Westchester's first hospital in 1869. At that time, approximately 14,000 residents called Yonkers their home when a small, dedicated committee of women from St. John's Episcopal Church opened the St. John's Invalid Home on Warburton and Ashburton Avenues to care for the poor of the parish in their time of sickness and misfortune. Officially incorporated as a charitable institution in early 1870, St. John's became the first hospital in Westchester County. Demand increased quickly and the fledgling institution responded. Later, in 1870, St. John's moved to the Grove House on Woodworth Avenue and Locust Street to accommodate 30 beds. In 1894, William and Eva Cochran donated buildings on Ashburton Avenue, from Palisade Avenue to North Broadway and further increased the capacity to 100 beds. What is today the oldest nursing school in the county, the Cochran School of Nursing, was established simultaneously. In 1896 the Cochran School graduated its first class. They were the first nursing school graduates in Westchester County and among the first in the nation. Today, more than 100 years later, we continue to offer one of the largest hospital-based nursing schools in the metropolitan region. That is the main reason why, during an era of chronic nursing shortages, St. John's can fill its nursing positions. In 1959, with help from the Andrus family and the Surdna Foundation, St. John's developed and built its present 14-story, 273-bed Andrus Pavilion' on North Broadway, which offered the most comprehensive healthcare services available. It was a revolutionary advancement in first aid when St. John's introduced Westchester's first motorized ambulance in 1918. Today we continue to deliver cutting edge technology as Westchester's leader in quality health care. St. John's was the first hospital in the greater New York metropolitan area to perform the ABBI breast biopsy procedure. We were the first to use a new, genetically engineered treatment for heart attack victims to prevent permanent heart damage. To better meet community need, we recently renovated and expanded our emergency department and re-dedicated it in honor of Iris and the late Marty Walshin, whose contributions to the St. John's community are immeasurable. Newborns at St. John's also benefit from the construction of our brand new high-tech nursery.