Pre-Access Services Representative

The Pre-Access Services Representative works under the direction of the Manager. The Pre-Access Services Representative possesses the highest customer services skills as the first touch in the patient experience chain. The Pre-Access Services Representative sets the tone for what is the first and can be the lasting impression of the patient's perception of Mosaic Life Care. The Pre-Access Services Representative performs all job duties in accordance with HCFA Compliance Guidelines. Will work as a scheduler for some outpatient clinic service areas. Accurately pre-registers all scheduled patients including updating patient demographic and insurance information. Conducts financial counseling to include collection of co-pays and deductibles and payment arrangements. Evaluates patients/guarantors for financial assistance. Pre-certifies insurance for scheduled admissions and/or required procedures to expedite reimbursement and avoid authorization penalties.

• Accurately pre-registers patients prior to the arrival and uses AIDET to prepare the patient for all aspects of their visit. Establishes/identifies medical record number. Accurately advises patient of any preparations needed for their scheduled services, and assures that they understand where to check-in for their appointment, including where to park and what doors to enter. Assists patients with wayfinding and ensures that they understand where to come and what to expect when they arrive.
• Accurately schedules Medical Center Outpatient and Clinic Provider visits. Reviews outpatient services to ensure that proper per-certification has been obtained by the Physician’s office.
• Researches the patient’s insurance to ensure that benefits are available for the service and to determine the patient’s financial responsibility. Works with patients’ insurance companies to determine if benefits are available for service at our facility.
• Relays to the patient how insurance will process their claim and what will be their estimated out-of-pocket expense. Researches prior visits for both Clinic and Medical Center to confirm any past due balances for the Guarantor. Collects estimated payments from patients or guarantors prior to their visit.
• Prescreens patients that may qualify for a third party assistance program and assist them with coordinating their interview and application process.
• Acts as a patient liaison in a centralized contact center for multiple Mosaic Life Care Clinics.
• Communicates patients’ needs to the providers through electronic communication.
• Triage patient calls using standards of care and responds appropriately.
• Complies with department standards for call length, speed to answer, and aids in prevention of abandoned calls.
• Identifies when a third party administrator is responsible for billing of service such as Workers Compensation or Lien.
• Other duties as assigned

• H.S. Diploma - High School Diploma or GED equivalent - Required
• Medical Terminology - Preferred

• Computer experience - Required
• Typing speed of 45 WPM preferred and 10 key by touch. - Required
• 1 Year - Experience in collection and\or insurance billing - Preferred
• 1 Year - Clinic office setting - Preferred

• Certified Healthcare Access Associate (CHAA) - and certification through ACA within 9 months of employment - Preferred Upon Hire

• Travel to off-site locations may be required. - Required