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Pre-Access Services Representative

Mosaic Life Care

Saint Joseph, MO

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JOB DETAILS
SKILLS
10-key (Tenkey) Numeric Keypad, Billing, Call Centers, Centers for Medicare and Medicaid Services (CMS), Claims Processing, Co-Payments, Computer Skills, Customer Support/Service, Demographics, Financial Management, Healthcare, Insurance, Interviewing Skills, Liens, Medical Office, Medical Records, Medical Terminology, Outpatient Care, Patient Assessment, Patient Registration, Physical Demands, Record Keeping, Reimbursement, Schedule Development, Standards of Care, Telephone Triage, Typing, Willing to Travel, Worker's Compensation
LOCATION
Saint Joseph, MO
POSTED
Today
Job Description

The Pre-Access Services Representative works under the direction of the Manager. The Pre-Access Services Representative possesses the highest customer services skills as the first touch in the patient experience chain. The Pre-Access Services Representative sets the tone for what is the first and can be the lasting impression of the patient's perception of Mosaic Life Care. The Pre-Access Services Representative performs all job duties in accordance with HCFA Compliance Guidelines. Will work as a scheduler for some outpatient clinic service areas. Accurately pre-registers all scheduled patients including updating patient demographic and insurance information. Conducts financial counseling to include collection of co-pays and deductibles and payment arrangements. Evaluates patients/guarantors for financial assistance. Pre-certifies insurance for scheduled admissions and/or required procedures to expedite reimbursement and avoid authorization penalties.

Responsibilities

  • Accurately pre-registers patients prior to the arrival and uses AIDET to prepare the patient for all aspects of their visit. Establishes/identifies medical record number. Accurately advises patient of any preparations needed for their scheduled services, and assures that they understand where to check-in for their appointment, including where to park and what doors to enter. Assists patients with wayfinding and ensures that they understand where to come and what to expect when they arrive.
  • Accurately schedules Medical Center Outpatient and Clinic Provider visits. Reviews outpatient services to ensure that proper per-certification has been obtained by the Physician's office.
  • Researches the patient's insurance to ensure that benefits are available for the service and to determine the patient's financial responsibility. Works with patients' insurance companies to determine if benefits are available for service at our facility.
  • Relays to the patient how insurance will process their claim and what will be their estimated out-of-pocket expense. Researches prior visits for both Clinic and Medical Center to confirm any past due balances for the Guarantor. Collects estimated payments from patients or guarantors prior to their visit.
  • Prescreens patients that may qualify for a third party assistance program and assist them with coordinating their interview and application process.
  • Acts as a patient liaison in a centralized contact center for multiple Mosaic Life Care Clinics.
  • Communicates patients' needs to the providers through electronic communication.
  • Triage patient calls using standards of care and responds appropriately.
  • Complies with department standards for call length, speed to answer, and aids in prevention of abandoned calls.
  • Identifies when a third party administrator is responsible for billing of service such as Workers Compensation or Lien.
  • Other duties as assigned

Education
  • H.S. Diploma - High School Diploma or GED equivalent - Required
  • Medical Terminology - Preferred

Work Experience
  • Computer experience - Required
  • Typing speed of 45 WPM preferred and 10 key by touch. - Required
  • 1 Year - Experience in collection and\or insurance billing - Preferred
  • 1 Year - Clinic office setting - Preferred

Licenses and Certifications
  • Certified Healthcare Access Associate (CHAA) - and certification through ACA within 9 months of employment - Preferred Upon Hire

Travel Requirements
  • Travel to off-site locations may be required. - Required


Qualifications

Skills and Abilities

Essential Technical/Motor Skills

Interpersonal Skills

Essential Physical Requirements

Essential Mental Abilities

Essential Sensory Requirements

Exposure to Hazards

Other Skills and Abilities

About Us

Mosaic Life Care is a health care system in northwest Missouri. With a vision of transforming community health by being a life-care innovator, Mosaic places the holistic needs of patients first by providing the right care at the right time and place, offering high value and quality health care.

Mosaic has a wide array of benefits to meet each employee's individual needs. Our benefits were designed by listening to people just like you. Mosaic also offers several perks with a focus on ensuring our employees feel valued, including concierge services, employee lounge, wellness programs, free covered parking, free on-site and virtual health clinics and many more. When paired with compensation and recognition, it is what continues to make us the employer of choice for employees at any stage of their journey.

About the Company

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Mosaic Life Care