Under the direct supervision of the Manager, Patient Access Service Center, the Patient Access Representative is responsible for the collection of information necessary to process incoming referrals for the multiple entities of Visiting Nurse Service and Affiliates. This information includes but is not limited to patient demographics, insurance verification of benefits, prior authorizations, reauthorizations, certificates of medical necessity, letters of medical necessity, and signed prescriptions from physicians.• Receives and responds to incoming patient referrals for multiple entities (e.g., VNS, Equipment & Supplies, Hospice, etc.) via fax, phone, or referral software in a timely and professional manner. Demonstrates excellent customer service skills during intake of the referral.
• Collects and enters required patient information to properly and accurately complete the referral into the patient management systems. This includes but is not limited to patient demographics, prescriptions, required testing documentation, and written orders.
• Obtains insurance benefits and authorizations for new orders, reorders, and resumption of care patients from payers and document in the appropriate patient management systems.
• Provides accurate and timely communication of patient insurance eligibility, coverage, and authorizations with referral sources, patients, and other VNSA departments. Secure an Advance Beneficiary Notice (ABN,) if required.
• Completes assigned reports, including but not limited to Reauthorizations, Medicare Capped Rentals, Unbilled Revenue, Open Work Order and Referral Activity reports accurately and efficiently.
• Communicates effectively with Distribution a time window for delivery of equipment and supplies and any specific instructions or concerns regarding delivery.
• Performs follow up on prescriptions, missing information, workers compensation C9, Certificates of Medical Necessity (CMN) with physician offices, patients, and referral sources.
• Must meet productivity and accuracy standards as set forth by the policies and procedures of the Patient Access Service Center Policy Manual.
• Assists the Patient Financial Service Department resolve denials resulting from intake in the Patient Access Service Center.
• Displays appropriate decision making skills as related to essential functions and responsibilities. Substitutes for other personnel as needed.
• Completes mandatory education and training in order to maintain organization and department specific competencies and requirements. Maintains applicable certification/licensure.
• Follows hospital and department policies and procedures or other applicable standards (e.g. Common Rule, HIPAA regulations) with special attention to attendance and punctuality, confidentiality, dress code and display of ID badge and safety.
Qualifications: Completion of high school or GED. One year of healthcare clerical or medical office billing experience or equivalent combination of relevant education and experience. Knowledge of Durable Medical Equipment. Excellent written and verbal communication skills required. Must demonstrate the ability to multitask and prioritize. Proficient with computer software applications and patient management systems. Minimum typing skills of 40 wpm.
Apply Online. Resume may be submitted upon completion of application.
Human Resources, Division of Recruitment and Retention
Akron General Health System
1 Akron General Avenue
Akron, Ohio 44307
Akron General Health System is an equal opportunity employer.