Patient Access Rep II

Must have Insurance Eligibility & Beneftis / Request Authorization experience The Patient Financial Clearance Rep job is responsible for completing patient insurance verification, eligibility and benefit determination requirements utilizing integrated electronic eligibility systems, payer websites, and by phone, for all insurance plans/IPAs within the scope of the patient financial clearance department. Interpret and document the appropriate copay, deductible, share of cost, coinsurance, maximum benefits level and/or available days for all scheduled and nonscheduled service. Contact patient as appropriate to obtain correct and undated information when necessary. Identifies risk associated with securing financial clearance prior to service date and escalates to clinic or other resources to find an appropriate course of action. Assist with patient inquiries regarding insurance benefits, authorization and payor specific requirements. Handles routine customer service inquiries and problems. Processes necessary admission/registration paperwork and obtains necessary documents for billing and compliance requirements. The PFC Rep position is intended as an entrylevel position for individuals with a background in patient admitting, authorization, or account reconciliation/billing experience in healthcare. It is expected that individuals on this level will acquire the necessary job skills, knowledge, and other qualifications through onthejob and/or formal training in order to advance to the Patient Financial Clearance Representative II level within 1 year. Essential Functions The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned. Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patients rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings. Must perform all duties and responsibilities in accordance with the Service Standards of the Hospital(s). Assures secure handling and accurate recording of payments collected at the pointofservice delivery. Builds a foundational understanding of the different health insurance coverage options and the related processes and procedures. Escalates any advanced or complex registrations to a more experienced team member. Greets patients and begins the registration process. Maintains professional communication with various PFC staff, medical center staff, physicians, guests, and patients regarding the admitting services rendered at Stanford Medical Center. Communication may consist of telephone correspondence or in person contact. Meets weekly individual productivity goals and standards while following planned priorities as set by the Team Manager/Coordinator. Performs other duties and responsibilities as assigned by the unit team manager or other PAS management personnel. Provides excellent customer service to all individuals with whom the employee has contact. Responsible for Cash Collection protocols. The specific job duties will be comprised of a combination of responsibilities from among the various areas of PFC & PAS operations including: Onsite, Ancillary, Financial Counselor, Access Unit, and Emergence Department Registration and Authorization Minimum Qualifications Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying. Education: High school diploma or GED equivalent Experience: One (1) year of progressively responsible and directly related work experience Knowledge, Skills, and Abilities These are the observable and measurable attributes and skills required to perform successfully the essential functions of the job and are generally demonstrated through qualifying experience, education, or licensure/certification. Ability to speak and write effectively at a level appropriate for the job Ability to work well with individuals at all levels of the organization Knowledge of computer systems and software used in functional area Knowledge of Medical Terminology Physical Requirements and Working Conditions The Physical Requirements and Working Conditions in which the job is typically performed are available from the Occupational Health Department. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job. 

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Reference number US_EN_99_025110_381732