Facility:Ohio Pediatric Care Alliance - SpringfieldDepartment:Patient Access - Offsite RegistrationSchedule:Full timeHours:40Job Details:Patient Access Representatives provide customer-service coverage and assume the responsibility for successful financial outcomes of all patient services. Under the general supervision of the Patient Access Manager, this position performs imperative duties, which may include, but not limited to appointment scheduling, registration, transcribing orders, insurance verification, telephone coverage, data entry, filing protected health information (PHI), patient referrals, and payment collection, while maintaining patient relations, customer satisfaction, and Dayton Children’s Hospital financial solvency.

　　Department Specific Job Details:

　　Primary Duties and Responsibilities - 50%Promptly fields and/or directs incoming calls and responds to patient and/or staff inquiries when necessary

　　Gathers and verifies all appropriate, confidential health and financial information from patient/guarantor/subscriber while using various computer software to assure payment for all authorized services. Obtains legal consent for treatment at the time of registration

　　Verifies insurance eligibility and benefits within a timeframe determined by Dayton Children’s Hospital

　　Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and 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 [EHR]

　　Collects out-of-pocket liabilities from patients upfront and applies, adjusts, and reconciles daily cash reports according to all organizational, state, and federal laws and regulations

　　Refers patient accounts to financial advocates when further explanation/education is needed regarding denied authorizations, out-of-pocket liabilities, coverage options, payment plans, etc.

　　Exhibits professionalism in appearance, hygiene, speech and conduct in accordance with organizational standards

　　Quality Improvement and Compliance - 25%Demonstrate awareness of department goals

　　Offer ideas and suggestions to make processes more efficient

　　Participate in the development of department goals and quality improvement indicators.

　　Keep the supervisor informed of any problems or concerns

　　Additional Responsibilities - 10%Demonstrates proficient customer-service skills by greeting and treating all patients and staff with respect, discretion and dignity using AIDET standards

　　Complies with all organizational, state, and federal laws and regulations related to patient privacy and confidentiality, such as the Health Insurance Portability and Accountability Act (HIPAA)

　　Demonstrates understanding of insurance protocols for referrals, co-payments, deductibles, allowances, etc., and analyzes information received to determine patients’ out-of-pocket liabilities

　　Education - 10%Participates in continuing education as needed to maintain current knowledge of role, revenue cycle and industry standards

　　Stays informed of state and federal regulations in relation to hospital reimbursement, and maintains communication with personnel in HIM departments and the business office to ensure accurate reimbursement

　　Stays current with all policies and mandatory education. Collaborates with patient access quality compliance coordinators, when in need of quality improvement measures, to improve overall revenue cycle accuracy

　　Performs other duties as assigned - 5%Education Requirements:

　　High School

　　Certification/License Requirements:

　　At Dayton Children's we believe that each moment counts with our patients, families and with each other.

　　We are moving at a fast pace and are looking for the right talent for our team at Dayton Children's. We want people who embody our values and want to become a part of the Dayton Children's difference. If this is you, apply today!

　　Our values:

　　Safety--We make safety our first priority.

　　Compassion--We deliver compassionate, family-centered care to all we serve.

　　Ownership--We are the pediatric care experts and act knowing that every patient, visitor and the hospital is our collective responsibility.

　　Collaboration--We work collaboratively to care for children, their families and each other.

　　Innovation--We continuously innovate to make Dayton Children's even better today and into the future.

　　Equity -- We strive for an environment in which all feel welcomed, valued and fairly treated in order to reach their full potential.

　　Dayton Children’s is proud to be an Equal Opportunity Employer who values diversity and will not discriminate against minorities, women, protected veterans, individuals with disabilities, or on the basis of age, color, gender identity, national origin, race, religion, sex, sexual orientation or transgender status.