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Patient Account Representative - Maternal Fetal Testing

Company: Providence Health & Services
Location: Orange
Posted on: June 19, 2022

Job Description:

Advance your career working at a Magnet recognized hospital known for clinical quality and patient safety. Providence St. Joseph Health offers a comprehensive range of benefits including but not limited to professional advancement, extensive health and program wellness offerings as well as competitive compensation, PTO, and retirement plans. We look forward to hearing from you!

We are looking for Patient Account Representative for the Maternal Fetal Testing Department at St. Joseph Hospital Orange.

Location: Orange, CA

Work Schedule: Full time - 80 Biweekly Hours

Shift: 8 hour, Day

Job Summary:

The ministry's primary representative for all financial concerns of our patients. Provides all services needed to resolve a patient's financial needs, without referring the patient to another specialist (except in highly unique situations.) Performs all financial clearance functions, including insurance verification, authorization, benefit analysis, financial counseling, and initial financial application completion. Understands all components of patient accounting and provides assistance with any billing or collection issue. Performs all pre-registration and registration functions for patients. Conducts patient interviews, explains hospital policies, collects patient liabilities and financially clears the patient prior to or at the time of service. Provides financial counseling when appropriate. Greets and serves patients in a professional, friendly, and respectful manner.

Essential Functions:

  • Able to perform full duties and tasks of a Registrar and able to understand, screen and assist patients with basic Financial Counseling needs.

  • Identifies all emergent/urgent admission accounts by pulling standard admission/census reports.

  • Verifies insurance eligibility and benefits on all emergent/urgent admissions to inpatient and observation and determines if an authorization or referral is needed for type of service.

  • Contacts patient's family or physician offices to obtain missing insurance information which can include policy number, group number, date of birth and insurance phone number if patient does not have insurance cards during emergent/urgent admission.

  • Notifies payer of all emergent/urgent admissions to inpatient or observation, communicates clinical requirements and contact information to Care Management department in a timely fashion.

  • Verifies patient demographics, obtains signatures on incomplete consent forms and inquires about other insurance and accident details for urgent/emergent admissions.

  • Documents all communication with patient, payer and Care Management in Meditech notes.

  • Screens for Medicare medical necessity and issues ABNs when appropriate.

  • Identifies all scheduled patient accounts by pulling standard scheduling reports and initiates pre-registration/registration process 4 days prior to service.

  • Collaborates with Central Scheduling, Ancillary Department Scheduling and Surgery Scheduling to identify add on patients (patient's scheduled for services less than 2 days from booking date).

  • Acts as liaison for patients with staff in the Patient Accounting Office.

  • Answers any questions posed by a patient related to a billing or financial issue.

  • Gains a deep knowledge of insurance benefits and understands fully intricacies of third party liability and workers' compensation.

  • Calculates patient liability and provides estimates, as per state regulations.

  • Understands TEFRA rules and identifies cases where TEFRA may apply, including financial calculations and completion of formal proposal for ministry coverage.

  • Understands and implements appropriately the ministry's policies on discounts, patient payment plans, and global services and offers these options to patients appropriately, including completion of patient contracts.

  • Understands fully the Authorization Policy and works closely with Case Management and leadership on patients whose services may be deferred.


    • Human development knowledge / skills. Ability to work with patients of all ages and explain payer benefits.

    • Demonstrates knowledge of all applicable compliance and legal requirements of the job based on the scope of practice of the position.

    • Excellent knowledge of applicable rules/regulations/guidelines governing Managed Care and Government sponsored coverage and reimbursement.

    • Preferred: Bilingual - fluent in English and Spanish.

    • Preferred: Knowledge of and demonstrated proficiency of the application of medical terminology, CPT and ICD9 Coding systems.

    • Preferred: Type 30 words per minute.

      Minimum Position Requirements:

      Education: Coursework/Training Pass Hospital Admitting Services formal Training and Competency Program within 6 months of hire.

      Experience :

      • 1 year Healthcare experience within a Patient Registration or Business Office setting.

      • Experience with insurance eligibility systems including Medicaid (Medi-Cal), Medicare and other commercial and private payer eligibility systems.

        Preferred Position Qualifications:

        Education: Associate's Degree Health Care or Business Administration.

        Experience: Experience with MEDITECH system.

        Licenses and Certifications: CHAM certification through the National Association of Healthcare Access Managers (NAHAM).

        Apply Today! Applicants that meet qualifications will receive a text message with additional questions from our Modern Hire system.

        Compassion. Dignity. Justice. Excellence. Integrity.

        These timeless values form the heart and soul of St. Joseph Hospital. They are the prime reason that we attract and retain high-caliber employees who believe in the sanctity of their work in our faith-based setting.

        As a result of this affinity, most of our employees have remained with us for at least five years. Over 40 percent of our new employees were either referred by friends or applied to work at St. Joseph based on our reputation. It is little wonder, then, that retention rate is significantly higher than the average for healthcare institutions in our community.

        Clinical Excellence

        When you take the latest in medical technology and place it in the hands of highly skilled clinicians, recognition is sure to follow. In July 2007, 2008 and 2009, St. Joseph Hospital was named one "America's Best Hospitals" for Orthopedic Care by U. S. News and World Report. This highly esteem recognition is testimony to our unique blend medical science and compassionate, values-based care.

        A haven that feels like home.

        St. Joseph Hospital offers a unique environment in which healthcare givers who share a kindred spirit can do important work and grow both spiritually and professionally. Here, values-based employees view their jobs not simply as careers but also as callings.

        Care to get acquainted? Then we warmly invite you to explore the many career opportunities offered by St. Joseph Hospital!

        St. Joseph Hospital provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, St. Joseph Hospital complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

        Positions specified as "on call/per diem" refers to employment consisting of shifts scheduled on as "as needed basis" to fill in for staff vacancies.

        Company: St. Joseph Hospital Orange

        Category: Community Services

        Req ID: R344225

Keywords: Providence Health & Services, Orange , Patient Account Representative - Maternal Fetal Testing, Other , Orange, California

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