Access Service Representative II--Rehab Business Svc-Sharp Grossmont Hospital-Full Time-Day Shift

Facility: Grossmont Hospital

City La Mesa

Department

Job Status

Regular

Shift

Day

FTE

1

Shift Start Time

Shift End Time

AHA Basic Life Support for Healthcare Professional (AHA BLS Healthcare) - American Heart Association

Hours :

Shift Start Time:

8 AM

Shift End Time:

4:30 PM

AWS Hours Requirement:

Additional Shift Information:

Weekend Requirements:

No Weekends

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$22.351 - $27.939 - $33.527

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.? The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

The role of this position is to coordinate the continuity of services required during the patient's episode of care in Outpatient Rehabilitation. This includes but is not limited to: ensuring orders and authorizations are obtained timely prior to initial scheduled visit and all regulatory documents are obtained and signed by M.D. prior to scheduling any continued visits outlined in the therapist POC. This position will be the main contact and interface between therapist, patients and MD offices, for all patients in assigned specialty programs, during their course of treatment. Including the processing of clean accounts to ensure maximum financial reimbursement.

Preferred Qualifications

• 3 Years Experience in a hospital patient registration, accounting and/or business services area

• AHA Basic Life Support for Healthcare Professional (AHA BLS Healthcare) - American Heart Association -PREFERRED

Essential Functions

• Admissions* Accurately completes all functions, at point of registration. Complies with all rules and regulations governing Medicare and Medi-Cal billing.* Verify accurate demographic and visit data ensuring no duplicate registrations.* Complete and accurate insurance selection and follow-up questions.* Insurance/Physician/Therapist notification - documented.* Dissemination of admission forms - Address Attestation, Attendance Policy, Financial Agreements, HMO Agreements, Tricare,* Medicare Secondary Payers, and Self Pay obtaining required signatures.* Check for MCARE overlapping charges for all accounts.* Any additional functions as described in Department memos or general updates, including assisting with prebilling functions as assigned.* Assures billing compliance standards are met.* Check DDE for Medicare eligibility.* Urgent admissions are verified and authorized immediately or upon next business day.* Ensure prescription with diagnosis is available prior to first scheduled visit.* System re-admitted accounts are organized, transitioned, and verified.

• SchedulingScheduling appointment from initial evaluation to the end of care. This may consists of varying scenarios based on the patient's referral for services. Employee must understand the bases of scheduling and ensures compliance with various insurance regulations, CMS requirements and CA State Licensing within these regulations and needs of the patient as it applies to various scheduling scenarios.* Single disciplinary* Cross disciplinary (multi therapies)* Cross Program* Cross Therapist licensure* Coordination of Transportation Services

• Finance and billing* Works timely, all bill holds on patient accounts that appear in ETM for assigned program.* Alerts manager, ensuring all coding is applied to accounts to ensure clean bill drop.* Ensures UB coding is completed, post evaluation, on all accounts requiring this information to bill.* Makes financial arrangements with patients who have self-pay accounts, co-insurance and co-payments.* Collect and reconcile co-payment batches before submission.* Audits charges for all disciplines for accuracy. Upload charges across the interface. Works/clears TES edits.* Follows Medicare guidelines for CAP Threshold dollars met and KX modifying accounts.* MPV is used with every accounts along with insurance portals to verify eligibility.* Performs billing functions accurately and efficiently. Problem solves error reports received, and corrects errors as necessary.

• Leadership* In conjunction with leadership, assures complete and accurate patient registration and helps identify areas for improvement and positive reinforcement.* In the absence of leadership, performs the leadership functions required to maintain departmental coverage and operations within established policies and guidelines.* Informs Leadership of special occurrences and/or staff issues in a timely manner.* Assists in the orientation and technical training of new employees or employees new to a position/area (checklists are completed).

• Other duties* Will provide cross coverage for other programs and services within the rehab center as needed.* Provides training and support to the other rehabilitation facilities/ enters.* All other related duties as assigned.* Performs all functions of an Access Service Representative - Patient Focus-Rehab in a manner that demonstrates exceptional understanding and proficiency.

• Records management* Maintains OP files on all patients within caseload. Ensures that necessary reports are faxed to physicians and Plan of Care and* Re-certifications are endorsed. Prepares all documentation to be forwarded to Medical Records Department after discharge.

• Report production* Runs reports as required/requested for specific programs served and worked timely.* Accounts open with DC notes, expired authorization and appointment beyond authorization.* Auto DC accounts at end of month.* Charting without charges.* Charges with no Admit Date.* Open accounts with no charges for 45 days.* Charges on rehab account from other departments.* Cancellation reports.* If required, runs patient round reports necessary to provide therapist with information on patient's status during rounds meeting.* If required, maintains patient status logs in Excel or other computer programs to tack status of patients and caseload of primary therapists.* Run scheduling reports for patient.* If time permits between patient contact and first appointment, runs all required forms to be completed prior to first visit and mails to patient's home.* Any reports within the Rehab decimation system that will ensure timely and clean bill drops.

• Teamwork and accountability* Demonstrates teamwork and cooperation through positive and supportive communication regarding department changes, goals, policies and procedures.* Promotes a positive work environment by respecting others, being honest, fair and consistent.* Take responsibility for department morale and involves management accordingly when issues that affect morale arise.* Ask necessary questions regarding new ideas or change to facilitate a positive reaction and support for innovation.* Brings an uplifting, positive approach to work assignments.* Accepts interpersonal differences and cooperates with other employees.* Accepts responsibility for own actions, personal growth and development.* Attends and participates in regularly scheduled staff meetings.Standards of Behavior - Consistently on a daily basis be an example of:* The Sharp Behavior Standards.* Must have AIDET.* Accept instruction, coaching

Knowledge, Skills, and Abilities

• Ability to manage large patient caseloads with minimal supervision and excellence in time-management.

• A self-starter with the ability to use independent judgement. Must be detail oriented with a working knowledge of Centricity, Cerner, OnBase Workflow, and a computerized scheduling and documentation system.

• Possess effective interpersonal and customer relations skills both verbally and in writing.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class