Patient Access Representative
To us, it's about living life to the fullest while serving our patients, teammates, neighbors and friends. We are dedicated and passionate in everything we do, seeking challenge and appreciating the routes that got us here. Whether our path is clinical or not, we all came to find balance and meaning in our lives within the work we are passionate about and the adventures we live.
Vail Health has become the world’s most advanced mountain healthcare system. Our updated 520,000-square-foot hospital opened in December 2020. This state-of-the-art facility provides exceptional care to all of our patients, with the most beautiful views in the area, located centrally in Vail.
Responsible for patient registration, admissions, and associated tasks which include information collection and validation, and requisitioning of orders and services. Insurance-related tasks include: verification, collection of co-payments, and collection of associated paperwork. Performs administrative functions, scheduling, answering phones, and coordinating general requests.
- 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.
- Establishes files, maintains information, and scans medical records in a timely and organized manner.
- 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.
- Attends and provides feedback for departmental staff meetings.
- 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
- 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.
Customer service and clerical experience
- Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
Benefits at Vail Health
- Competitive Wages & Family Benefits: Competitive wages, parental leave, housing programs and childcare reimbursement to support the cost of living in a mountain community.
- Comprehensive Health Benefits: Top-quality health care package including vision, dental and medical with options of flexible spending and health savings accounts.
- Education Assistance: We are proud to offer tuition and student loan assistance programs.
- Paid Time Off: Roughly five weeks in your first year of employment and continues to grow each year.
- Retirement & Supplemental Insurance: 403(b) Retirement plan with matching potential, life insurance, short and long-term disability, and more.
- Recreation Benefits, Wellness & More: Recreation discounts, pet insurance and a $1,000 annual wellness reimbursement program.
As a condition of employment, Vail Health requires COVID-19 vaccination of all clinical and non-clinical staff.