Outpatient Access Rep - Yale New Haven Health

Overview:To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

Responsible for coordinating various access functions, such as: registration, insurance verification and financial clearance, agency/free care application process and follow-up, and account resolution functions. Ensures positive interactions with patients, family members, medical staff, third party representatives and hospital personnel. Promotes good customer service in the work environment. Effectively utilizes all computer systems to ensure that the responsibilities of the Registration Department are met. Performs certain statistical and QA functions. Develops new procedures and participates in the planning and implementation of system improvements to enhance the operating functions of the department.

EEO/AA/Disability/VeteranResponsibilities:

• 1. CUSTOMER SERVICE - Creates a patient/family, physician and employee experience that exemplifies caring, understanding, efficiency and overall quality of service. Demonstrates the ability to balance customer service with the financial needs of the hospital.
• 1.1 Identifies events where the service to a customer was less that optimal and escalates issues appropriately.
• 2. COMPUTER KNOWLEDGE - Maintains knowledge of current computer systems, for example those used in registration, scheduling, accounts receivable, patient care, patient tracking and Web based on-line eligibility systems.
• 2.1 Utilizes Microsoft packages.
• 3. REGISTRATION FUNCTIONS - Exhibits a thorough understanding of various insurance carrier/verification guidelines and knowledge of third party payor policies. Stays abreast of insurance changes as they affect the verification and processing of accounts. Takes appropriate actions to address problems when identified.
• 3.1 Verifies eligibility as outlined in departmental procedures. Assists in quality assurance audits utilizing various reports and/or worklists.
• 4. CHART PREPARATION - Ensures the timely generation and distribution of documents as required by departmental procedure to ensure timely processing of the patient's medical record.
• 4.1 Follows departmental procedures in obtaining required medical record documentation.

Qualifications:

EDUCATION

High School graduate with demonstrated continuing education at a college level program or equivalent experience. Associate or Bachelor's Degree preferred.

EXPERIENCE

One or two years experience in a hospital Admitting/ED Registration Department with emphasis on registration, third party insurance verification and financial clearance dealing with all aspects of medical insurance and eligibility requirements preferred. Prior customer service experience required.

SPECIAL SKILLS

Excellent interpersonal skills and leadership ability. Has the ability to effectively communicate with all disciplines and all levels of customers. Strong working knowledge of PCs and related software to prepare a variety of reports. Must be able to work under constant pressure and use strong organizational skills. Must have knowledge of third party insurance, financial clearance, eligibility, billing & reimbursement, cash collection. Ability to interpret federal/state regulations and various governmental program guidelines (including free care). Demonstrates working knowledge of Medical Terminology. Bilingual (Spanish-speaking) ability is preferred.