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Location:

Redfield, SD

Worker Type:

Regular

Work Shift:

Day Shift (United States of America)

Redfield Community Memorial Hospital and Clinic is seeking a qualified individual to join our team!

Position Highlights

Job Summary

The Patient Access Rep is responsible for insurance verification and preauthorization functions within the Meditech B/AR, Scheduling and Admission Applications. Using ICD conventions, the Patient Access Rep codes scheduled outpatient encounters and checks for correctness and completeness prior to the date of service.

The Patient Access Rep handles all aspects of scheduling, pre-registering, registering or admitting patients for services at CMH.

The Patient Access Rep provides the described services for patients of all ages who present to the hospital for treatment or services. Demonstrating knowledge of the principles of growth and development, the Patient Access Rep possesses the ability to respond to specific issues and data reflective of the client’s status. This person is responsible for expert relations with the clients, customers, hospital staff, physicians and physicians’ office personnel.

Essential Job Functions:

+ Receive requests and schedule appointments for elective services from physician offices, hospital departments and/or patients. Utilizing the appropriate procedures, obtain accurate information to book appointments and enter into the computer system.

+ Interview patients or their representative by telephone to obtain accurate and current demographic, financial and insurance information required for procedures, pre-registration, registration, billing and claims filing. Work directly with physicians’ offices to obtain necessary insurance information when applicable.

+ Obtain insurance verification and preauthorization for patients receiving services and document such in the hospital computer system.

+ Pre-register patients, utilizing the same detail that is required for registration

+ Follow up incomplete patient registration information and make necessary phone calls or other arrangements to obtain the information.

+ Refer stat orders to appropriate department within an acceptable time frame.

+ Provide procedure-specific instructions to the customer including information necessary to prepare for and complete the procedure. Send out appropriate instructions to the customer when applicable.

+ Completes necessary duties as assigned by department head and adheres to policies and procedures.

+ Establish and maintain positive inter-personal relationships.

+ Respect confidentiality of patients, visitors, hospital personnel and hospital business in general.

+ Interact with customers in a competent manner appropriate to their ages.

+ Consistently utilize time in an effective manner

+ Demonstrate reliability in attendance and punctuality

+ Other duties as assigned

Marginal Job Functions:

+ Provide information per hospital policy to visitors and hospital department staff

+ Understand the responsibilities of maintaining and updating skills and job knowledge

+ Possesses initiative, independent judgement and ability to organize and direct one’s own work.

Essential Physical Demands:

+ Sedentary to light work involving exerting up to 20 pounds of force occasionally, and up to 10 pounds of force frequently and a negligible amount of force consistently. Some walking is also required.

+ Good manual dexterity necessary for keyboarding/typing, dialing, filing, holding, indexing, inserting, lifting, opening, sorting, stapling, turning and writing. Job involves frequent, repetitive motions of the hands/wrists involved with computer entry.

+ Good communication, problem solving skills, and hearing are necessary when dealing with patients, visitors, nurses, physicians and other staff.

Work Environment:

+ Will be working in a clean, well-lit, ergonomically-planned area

+ Occasional exposure to odors, dust, and changes in environmental temperature.

Equipment Used to Perform Job:

+ Must be familiar with and able to operate all equipment utilized in the department, including computers, copy machines, fax machines, telephones, and printers.

Mental Requirements:

• Reading, simple ☒ Spatial ☒ Tending

• Reading, complex ☐ Form ☒ Precision working

• Writing, simple ☒ Clerical ☒ Follow instructions

• Writing, complex ☒ Compiling ☒ Influence others

• Math skills, simple ☒ Coordinating ☒ Time requirement

• Math skills, complex ☐ Analyzing ☐ Memorization

• Tasks, simple ☐ Synthesizing ☒ Problem solving

• Tasks, complex ☐ Supervising ☒ Independent judgment

• Driving ☒ Instructing ☒ Decision making

Potential Job Stressors:

+ Must be able to deal daily with professional, non-professional and medical staff. There are times of intense activity, coupled with down times. Must be able to deal with potential unpleasant job activities resulting from frequent interruptions and/or distractions, customer demands, constant ringing of phone. Must be able to effectively prioritize tasks midst these activities.

+ Must be flexible in work hours and job demands.

Education:

+ Requires high school education

Licenses/Certificates: N/A

Experience:

+ Advanced secretarial or clerical training desired. Previous experience preferred.

+ Computer knowledge and knowledge of medical terminology necessary.

+ Must be able to complete and synthesize principles of ADM, BAR, and CWS applications.

+ Proficient in use of internet, following ASL internet usage policy.

At Avera, the way you are treated as an employee translates into the compassionate care you deliver to patients and team members. Because we consider health care a ministry, you can live out your faith, uphold the dignity and respect of all persons while not compromising high-quality services. Join us in making a positive impact on moving health forward.

The policy of Avera to provide opportunities for all qualified employees or applicants without regard to disability and to provide reasonable accommodations for all employees or applicants who may be disabled. Avera is committed to ensuring compliance in accordance with the Americans with Disability Act. For assistance, please contact HR Now at 605-504-4444.

Additional Notices:

For TTY, dial 711

Avera is an Equal Opportunity/Affirmative Action Employer: Minority/Female/Disabled/Veteran/Sexual Orientation/Gender Identity.