Outpatient Access Rep

Greenwich, CT
Jan 3, 2019

Share:

Job Description

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.
SUMMARY
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/Veteran.
Weight (%) RESPONSIBILITIES
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.
20 1.
Identifies events where the service to a customer was less that optimal and escalates issues
appropriately.
1 .1
1 .2 Contributes to a positive work environment by actively discouraging -we versus they- thinking.
1 .3 Works with clinical staff to ensure smooth efficient patient flow.
COMPUTER KNOWLEDGE - Maintains knowledge of current computer systems, for example those used in
registration, scheduling, accounts receivable, patient care, patient tracking and eb based on -line eligibility
systems.
2.
2 .1 Utilizes Microsoft packages.
Participates in internal and external committees as related to the enhancement or development of
computer systems.
2 .2
Monitors, evaluates and responds to system abnormalities.
Recognizes when to make workflow changes and when to escalate issues appropriately.
2 .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.
Verifies eligibility as outlined in departmental procedures .
Assists in quality assurance audits utilizing various reports and/or worklists.
3 .1
Establishes and maintains open communication with all insurance provider representatives and
physician offices.
3 .2
Ensures proper account documentation of benefits and authorizations, and follow- up by staff during and
after the patient's visit.
3 .3
Page 1 of 4
JOB DESCRIPTION
YALE NEW HAVEN HEALTH
GRADE:
Outpatient Access Rep 001630
Access Representatives
TITLE:
DEPARTMENT:
POSITION CODE:
VERSION 1 : 15-SEP-14 (APPROVED)
REPORTS TO: FLSA STATUS: NON_EXEMPT
DEPARTMENT CODE: 68080
SCHEDULE: NEY 22A
Supervisor Access
Weight (%) RESPONSIBILITIES
Adheres to standards for the collection of cash and the daily cash reconciliation process. Enters
financial data into the computer systems and maintains accurate financial records. Retains cash logs
and report statistical data as required. Collects cash payments appropriately for patients, makes
referrals for financial counseling, determines the necessity of third party sponsorship and processes
patients in accordance with the YNHH policies and procedures. Assists in arranging payment.
3 .4
3 .5 Provides input and offers solutions for improvement on operational workflow.
3 .6 Assists in quality assurance audits utilizing various reports and/or worklists.
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.
4 .1 Follows departmental procedures in obtaining required medical record documentation.
Ensures department maintains an accurate system of sorting, dating and filing documents to ensure the
integrity of patient information.
4 .2
Ensures that an accurate audit trail is maintained of the document retrieval process by following
established documentation procedures.
4 .3
Page 2 of 4
JOB DESCRIPTION
YALE NEW HAVEN HEALTH
GRADE:
Outpatient Access Rep 001630
Access Representatives
TITLE:
DEPARTMENT:
POSITION CODE:
VERSION 1 : 15-SEP-14 (APPROVED)
REPORTS TO: FLSA STATUS: NON_EXEMPT
DEPARTMENT CODE: 68080
SCHEDULE: NEY 22A
Supervisor Access
REQUIREMENTS
EDUCATION (number of years and type required to perform the position duties):
High School graduate with demonstrated continuing education at a college level program or equivalent experience .
Associate or Bachelor's Degree preferred.
EXPERIENCE (number of years and type required to meet an acceptable level of performance):
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.
ACCOUNTABILITY (how this position is held accountable for such as goals achievement, budget adherence, or
other areas of accountability):
the accuracy and timeliness of patient registration, patient admissions and discharges; the completeness of all
required documentation involved in pre-certification, insurance verification and financial clearance of patient accounts .
Obtains the necessary demographic, clinical and financial information to ensure that patients are admitted and /or
registered properly in adherence with established departmental guidelines, hospital policies and medical staff
by-laws as it pertains to all of the functions. Relates federal/state regulations and governmental program guidelines
throughout the free care application process.
COMPLEXITY (describe planning, problem solving, decision making, creative activity, or other special factors
inherent in the responsibilities of this position):
In personal and job-related decisions and actions, consistently demonstrates the values of integrity (doing the right
thing), patient-centered (putting patients and families first), respect (valuing all people and embracing all differences),
accountability (being responsible and taking action), and compassion (being empathetic).
Position requires application of a variety of policies and procedures in dealing with employees, patients, families,
physicians and their staffs. Due to the complexity and diversity of the interaction with various disciplines, must have
the ability to assess situations and make sound judgments in rectifying issues. Due to the ever -changing healthcare
industry environment, must have the ability to understand how changes affect patients and hospital reimbursement ,
as well as the overall impact to the registration operation. Must be capable of independent judgment in dealing with
clinical staff, patients and families. Maintains a variety of statistical reports to track quality assurance, customer
service and employee productivity.
LICENSURE/CERTIFICATION:
INFORMATIONAL
SPECIAL WORKING CONDITIONS AND PHYSICAL DEMAND:
Departmental Approval: Sujing Nettland Date:
Share:

Not ready to apply, but interested in working at Yale New Haven Health?

Join our Talent Network

Job Info

Job: 3379

Department: HVC 500 West Putnam
Category: Admin Support
Hours: 40.00

Similar Jobs

Radiology Tech, per diem

Greenwich, CT

Radiology Tech, per diem

Greenwich, CT