West Tennessee Healthcare

Public, nonprofit hospital system with centers

Patient Access Representative 1

Clinical Support & Patient AdministrationPosted on Nov 6

Full-timeJackson, TN, USANo salary listedIn-person

About the Job

Requirements

High school graduation or equivalent is required.
One to two years of health care or related experience is preferred.
The representative must communicate financial and service information clearly to patients, guarantors, family members, and other customers.
The representative must be able to collect and document patient information and work with medical staff, nursing, ancillary departments, insurance payers, and external sources.

Responsibilities

Maintain the department's best-practice routine and keep daily work queues and correspondence current according to department guidelines and policies.
Interview patients and collect and record information needed for pre-registration and registration as part of the financial-clearance process.
Assign the correct insurance payer plan choice and billing address in the automated patient accounting system and verify relevant group and identification numbers.
Complete patient registration according to established policies and procedures.
Inform families with inadequate insurance coverage about government and financial-assistance programs.
Perform initial financial screening and refer accounts for financial counseling or appropriate eligibility assessments.
Obtain required referrals and treatment authorizations for all patient types, contacting payers for approval when needed.
Complete initial medical-necessity checks and refer cases to the designated area when medical necessity fails or referrals or authorizations are denied.
Advise the next-level leader of possible postponement or deferral of elective or non-emergent admissions that have not been approved before the service date.
Maintain accurate files for pre-processing information.
Investigate, resolve, and document patient problems in a timely and efficient manner.
Complete applicable pre-registration, registration, insurance and benefit verification, certification, referral management, patient-liability collection, and medical-necessity checks.
Screen patients and guarantors for financial counseling, verify eligibility and benefit levels, coordinate referrals, and obtain treatment authorizations.

Category:

Admin Support

City:

Jackson

State:

Tennessee

Shift:

8 - Day (United States of America)

Job Description Summary:

This position is responsible for completing the financial clearance process within Patient Access Services and creating the first impression of WTH’s services to patients and families and other external customers. The PAS Representative must be able to articulate information in a manner that patients, guarantors, and family members understand so they know what to expect and have an understanding of their financial responsibilities. This position assumes responsibility for collecting and documenting information on behalf of the patient. The PAS Representative may be responsible for completing the pre-registration, registration, insurance verification, benefits verification, certification, referral management, patient liability collections, and medical necessity check -- as well as interviewing patients and guarantors to obtain information to screen for financial counseling, verifying eligibility and corresponding benefit levels, coordinating referrals, and obtaining treatment authorizations. The PAS representative will also work with medical staff, nursing, ancillary departments, insurance payers, and other external sources to assist families in obtaining healthcare and financial service

ESSENTIAL JOB FUNCTIONS:

Process - Maintains the best practice routine per department guidelines.
Daily work queues are maintained at acceptable levels according to department policies.
Correspondence worked daily to current.
Registration - Performs financial clearance process by interviewing patients and collecting and recording all necessary information for pre-registration and registration of patients.
Ensures that proper insurance payer plan choice and billing address are assigned in the automated patient accounting system.
Verifies relevant group/ID numbers.
Completes the registration process according to established policies and procedures.
Informs families with inadequate insurance coverage regarding financial assistance through government and financial assistance programs.
Performs initial financial screening and refers accounts for financial counseling and/or appropriate eligibility assessments.
Ensures all referrals and treatment authorizations for all patient types have been obtained according to the outlined requirements.
If not obtained, contact payers for approvals.
Completes initial medical necessity checks.
Refers to the designated area if medical necessity fails or if referrals /authorizations are denied.
Communication & Miscellaneous - Advises next-level leader of possible postponement or deferrals of any elective/non-emergent admission which has not been approved prior to service date.
Maintains accurate files for pre-processing information as required.
Investigates, resolves, and documents patient problems in a timely and efficient manner.
Maintains accurate files for pre-processing information.

JOB SPECIFICATIONS:

EDUCATION:

High School Graduate, or equivalent

LICENSURE, REGISTRATION, CERTIFICATION:

EXPERIENCE:

1-2 years of health care or related experience preferred.

NONDISCRIMINATION NOTICE STATEMENT

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, disability, religion, national origin, gender, gender identity, gender expression, marital status, sexual orientation, age, protected veteran status, or any other characteristic protected by law.

About the Company

West Tennessee Healthcare

Public, nonprofit hospital system with centers

West Tennessee Healthcare is a public, not-for-profit health system based in Jackson, Tennessee, anchored by Jackson-Madison County General Hospital with 635 beds and several centers of excellence, including Women and Children, Cancer, Emergency, Rehabilitation, and Heart care. Care is delivered through a network of facilities offering inpatient, outpatient, emergency, and specialty services, with centers coordinating to provide comprehensive treatment across the region. It differentiates itself by its not-for-profit, community-focused model and integrated centers of excellence under one regional system, rather than a for-profit, multi-provider setup. Its goal is to provide broad, community-focused healthcare across West Tennessee through an integrated hospital network, ensuring access to acute, specialty, emergency, rehabilitation, and cancer and heart services for residents in the area.

Company size: 1,001-5,000
Company stage: Not listed
Total funding: Not listed
Headquarters: Jackson, MS
Founded: 1950

Recently Posted Jobs

Explore more opportunities at West Tennessee Healthcare

See more jobs