Patient Access Representative Job - Rancho Cucamonga - CBO, CA

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We are seeking a friendly, compassionate, and organized patient access representative to join our growing healthcare team. In this role, you will work at our centralized call center.  You will be responsible for appointment scheduling and routing calls, sorting corresponding, and maintaining the organization of our office. Performs clinical benefit verification and referrals in accordance with business office and insurance industry policies and procedures. 
 
RESPONSIBILITIES AND DUTIES
 
  • Able to answer and route large number of calls in a prompt and courteous manner
  • Answer patient questions and provide assistance and directions when necessary
  • Utilize our medical office software to schedule new and follow-up appointments for our patients
  • Register new patients and update necessary records, including patient demographics and insurance coverage
  • Ability to verify authorizations
  • Maintain confidentiality of all patient records
  • Uphold the positive reputation of our medical office by always treating visitors in a friendly, welcoming, and compassionate manner
  • Organize and track upcoming appointments by working with daily scheduling reports and staff.
  • Review accounts for completeness of insurance information, for the necessity of referrals, pre-      certifications, and prior authorizations to ensure reimbursement at the highest level possible.
  • Verify insurance with respective insurance companies and file all necessary forms for pre-certifications, and referral requests.
  • Verify, update and enter insurance information into the electronic practice management system (EPM) including policy information, benefit coverage, and referrals.
  • Identify any potential non-coverage issues and effectively communicate this information to our patients.
  • Provide timely responses to voicemail and email inquiries.
  • Provide feedback to scheduling staff or appropriate business office staff of necessary waivers or special instructions that may be needed.
  • Communicate with patients as needed to acquire necessary information.
  • Maintain up to date reference guides and payer requirements.
  • Participate in regular team meetings; provide positive feedback and suggestions.
  • Other duties as assigned
 
JOB QUALIFICATIONS To perform the job successfully, an individual must be able to perform each essential duty and responsibility satisfactorily with or without reasonable accommodation.  The requirements below are representative of the minimum knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties and responsibilities. 
 
SUPERVISORY RESPONSIBILITY
None
 
KNOWLEDE/SKILLS/ABILITIES
Bilingual (Spanish) Preferred
Data Entry Skills
Friendly and compassionate disposition
Excellent organizational and time management skills
Strong interpersonal communication skills
 
EDUCATION AND/OR EXPERIENCE
Associate degree (AA) from two-year college or technical school; and/or one-year related experience and/or training or equivalent combination.
 
CERTIFICATES, LICENSES, REGISTRATIONS
None
 
 
Amount of Time
Activity
None
<1/3
1/3-2/3
>2/3
Stationary position (sit and/or stand):  Ability to stay in a stationary position, particularly for sustained periods of time.
 
 
 
x
Move, traverse: Moving about on foot to accomplish tasks, particularly for long distances or moving from one work site to another.
 
 
x
 
Operate, activate, use, prepare, inspect place, detect and/or position: Picking, pinching, typing or otherwise working, primarily with fingers rather than with the whole hand as in handling. Applying pressure to an object with the fingers and palm. Perceiving attributes of objects, such as size, shape, temperature or texture by touching with skin, particularly that of fingertips. Constantly operates a computer and/or other productivity machinery
 
 
 
x
Ascend/descend, work atop, traverse: Ascending or descending ladders, stairs scaffolding, etc. and maintaining body equilibrium to prevent falling.
 
x
 
 
Position self to stoop, kneel, crouch or crawl: bending body downward, bending legs at the knees, moving about on hands and knees.
 
x
 
 
Talking: Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken information to other workers accurately, loudly, or quickly.
 
 
 
x
Hearing: Perceiving the nature of sounds at normal speaking levels with or without correction. Ability to receive detailed information through oral communication, and to make the discriminations in sound.
 
 
 
x
Computer use: Use a computer the collect and disseminate information, to research issues and to process information.
 
 
 
x
 
Indicate the type of work that best describes the                Indicate special vision requirements. Select all that apply.
amount of lifting and exerted force required.
                                   
 
Sedentary work. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Involves sitting most of the time, but may involve walking or standing for periods of time.
 
x
Close vision - clear vision at 20 inches or less
x
Distance vision - clear vision at 20 feet or more
x
Color vision - ability to identify and distinguish colors
x
Peripheral vision - ability to observe an area that can be seen up and down or to the left and right while eyes are fixed on a given point
x
Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. Physical demands are in excess of sedentary work.  Light work usually requires walking or standing a significant amount of time.
 
x
Depth perception - three-dimensional vision, ability to judge distances and spatial relationships
x
Ability to adjust focus - ability to adjust the eye to bring an object into sharp focus
 
No special vision requirements
   
 
Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 20 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects.
     
 
Heavy work. Exerting up to 100 pounds of force occasionally, and/or up to 50 pounds of force frequently, and/or up to 20 pounds of force constantly to move objects.
     
 
Very heavy work. Exerting in excess of 100 pounds of force occasionally, and/or in excess of 50 pounds of force frequently, and/or in excess of 20 pounds of force constantly to move objects.
     
           
 
Indicate any physical demands that aren't listed or if there are any peculiar physical movements.  Include frequency, intensity, and/or duration.
 
 
 
 
WORK ENVIRONMENT
Select the amount of time spent exposed to each of the conditions on-the-job. 
 
Amount of Time
Exposure of
None
<1/3
1/3-2/3
>2/3
Hot, cold, wet, humid, or windy conditions caused by the weather
X
 
 
 
Extreme cold - Exposure to non-weather-related cold temperatures
X
 
 
 
Extreme hot - Exposure to non-weather-related hot temperatures
X
 
 
 
Wet and/or humid - Contact with water or other liquids; or exposure to non-weather-related humid conditions
X
 
 
 
Fumes or airborne particles
X
 
 
 
Toxic or caustic chemicals
X
 
 
 
Risk of electrical shock
X
 
 
 
Work near moving mechanical parts
X
 
 
 
Work with explosives
X
 
 
 
Vibration - Exposure to a shaking object or surface
X
 
 
 
 
Indicate the noise level that best                     Indicate the type of hearing that is required.
describes the work environment.
 
Very quiet
 
X
Ability to hear alarms on equipment
 
Quiet
 
X
Ability to hear fellow employees
x
Moderate Noise
 
x
Ability to hear instruction from management
 
Loud Noise
     
 
Very loud noise
     
 
MENTAL DEMANDS
Indicate each of the mental abilities that are required to perform the essential functions of this position.
 
Comprehension
X
Ability to understand, remember and apply oral and/or written instructions or other information
X
Ability to understand, remember and communicate routine, factual information
X
Ability to understand complex problems and collaborate and explore alternative solutions
X
Ability to understand opposing points of view on highly complex issues and to negotiate and integrate different viewpoints
 
Organization
X
Ability to organize thoughts and ideas into understandable terminology
X
Ability to organize and prioritize own work schedule on short-term basis
 
Ability to organize and prioritize work schedules of others on short-term basis
 
Ability to organize and prioritize work schedules of others on long-term basis
 
Reasoning and Decision Making
X
Ability to apply common sense in performing job
X
Ability to make decisions which have moderate impact on immediate work unit
X
Ability to make decisions which have significant impact on immediate work unit and monitor impact outside immediate work unit
X
Ability to make decisions which have significant impact on the department’s credibility, operations and services
 
Communication
X
Ability to understand and follow basic instructions and guidelines
X
Ability to complete routine forms, using existing form letters and/or conduct oral communication
X
Ability to compose letters, outlines, memoranda and basic reports and/or to orally communicate technical information
X
Ability to communicate with individuals utilizing a telephone
x
Ability to express or exchange ideas by means of the spoken word, communicating orally with others accurately, loudly and quickly
 
Ability to make informal presentations, inside and/or outside the organization
 
Ability to formulate complex and comprehensive materials such as legal documents, authoritative reports, official publications of major scope and impact and/or to make formal presentations
 
Mathematics
 
No mathematical ability is required
X
Ability to count accurately
X
Ability to add, subtract, multiply, divide and to record, balance and check results for accuracy
 
Ability to compute, analyze and interpret numerical data for reporting purposes
 
Ability to compute, analyze and interpret complex statistical data and/or to develop forecasts and computer models
DISCLAIMER
This job description is intended to convey information essential to understanding the current scope of the job and the general nature and level of work performed by current job holder(s) within this job. This job description is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities or working conditions associated with the position.  Pacific Eye Institute (PEI) reserves the right to change the expectations of the job and assign or reassign duties and responsibilities at any time.
 
 
ACKNOWLEDGEMENT
I have reviewed and I understand the job description, including but not limited to requirements, essential functions, and duties of the position.  I am able to perform all of the essential functions of the job, with or without accommodation.
 
Employee Name (Print)________________________________                   _______Employee ID#________
 
 
Signature________________________________                                                              Date_________               
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