Patient Access Central Unit Rep in Salt Lake City, UT at Parallon

Date Posted: 4/3/2018

Job Snapshot

Job Description



Job Summary – The PTAC Central Unit Representative is responsible for timely and accurate processes associated with some or all of the following:

• Pre-registration

• Insurance verification

• Pre-Certification

• Insurance Notification

Supervisor – PTAC Central Unit Manager

Supervises – not applicable

Duties (included but not limited to):

Duties will be performed by each individual depending on assignment of responsibilities:

• Perform pre-registration and insurance verification within 3-5 days prior to date of service for both inpatient and outpatient services. For notification received with less than 3 days’ advanced notice perform within 24 hours of notification.

• Follow scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information in the approved standard format

• Assign Insurance Plans (IPlan’s) accurately

• Perform electronic insurance eligibility confirmation when applicable and document results

• Complete Medicare Secondary Payor Questionnaire as applicable for retention in imaging system (i.e. OnBase)

• Calculate patient cost share and be prepared to collect via phone or make payment arrangement

• Contact patient via phone (with as much advance notice as possible, preferably 48 hours prior to date of service) to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct patient on where to present at time of appointment

• Receive and record payments from patient for services scheduled.

• Utilize appropriate communication system to facilitate communication with hospital gatekeeper

• Ensure appropriate documentation is entered in standard format on the patient record. This should be performed in the applicable Health Information System (i.e. Meditech) and if necessary any other subsidiary systems if they are not automatically updated.

• Contact physician to resolve issues regarding prior authorization or referral forms

• Research Patient Visit History to ensure compliance with payor specific payment window rules

• Perform insurance verification and pre-certification follow up for prior day’s walk in admissions/registrations and account status changes by assigned facility as per SSC

 

guidelines.

• Communicates with hospital based Case Manager as necessary to ensure prompt resolution of pre- existing, non-covered, and re-certification issues

• Meets/exceeds performance expectations and completes work within the required time frames

• Implements and follows system downtime procedures when necessary

• Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"

• Other duties as assigned

 

EDUCATION

High school diploma or GED required.

EXPERIENCE

One year of related experience required.