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Position Details

Department: Pre Access Services
Category: Patient Access
Location: Phoenix
Posting #: 419446
Date Posted: 10/19/2018
Employee Type: Regular

Position Summary

The Pre-Access Specialist is responsible for the accurate and complete pre-registration, insurance verification and authorization of scheduled professional and hospital services.

PCH Values

  • Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
  • Excellence in clinical care, service and communication
  • Collaborative within our institution and with others who share our mission and goals
  • Leadership that set the standard for pediatric health care today and innovations of the future
  • Accountability to our patients, community and each other for providing the best in the most cost-effective way.

Position Duties

  1. Contacts the patient's parent/responsible party by phone and obtains all current demographic and insurance and employer information, making updates and creating accounts in the EMR system, as appropriate.
  2. Courteously answers the telephone and answers all questions in a timely manner. Refers uninsured and underinsured patients to the Financial Counselor via phone transfer and/or work queue assignment.
  3. Maintains a positive working relationship with patients/guarantors, insurance companies, government entities, clinical personnel, co-workers and management to promote teamwork, cooperation and a positive public image for PCH.
  4. Notifies the patient/guarantor of any applicable deductible, co-pay, lifetime maximum, pre-existing condition restrictions, previous unpaid liabilities, and other out-of-pocket expenses and request payment.
  5. Obtains all necessary authorizations for scheduled professional and hospital procedures and office visits and accurately documents all information in the appropriate fields and/or account notes.
  6. Organizes, prioritizes and reviews daily work activity to ensure that complete, accurate and compliant pre-registration has been performed.
  7. Participates in a variety of unit and hospital educational programs to maintain current skill and competency levels.
  8. Verifies insurance benefits using an automated verification solution tool, insurance carrier websites, or by phone, and accurately documents all information in the appropriate fields and/or account notes.
  9. Performs miscellaneous job related duties as requested.

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Position Qualifications

Please review the following qualifications and specify whether you meet each of the requirements listed.
Do you meet this requirement?
Education
1. Associates in Business or related field or combination of education and experience. Required
Do you meet this requirement?
Experience
1. Experience with EMR, document management and imaging system, or Payor Websites platform. Required
2. Experience requesting Professional/Clinic or Hospital Authorizations Required
3. Minimum of one year of medical registration experience. Preferred
Do you meet this requirement?
Special Skills
1. Ability to work effectively in a high-volume, fast-paced environment with changing priorities. Must possess customer-focused attitude and professional demeanor. Required
2. Excellent communication skills (Written and Oral). Required
3. Knowledge of Medical Terminology and ICD/CPT codes and an understanding of HIPAA privacy laws. Required
4. Analytical skills with strong attention to detail and a high degree of accuracy. Required
5. Bilingual (Spanish). Preferred
Physical Requirements & Occupational Exposure/Risk Potential
1. Physical Requirement - Climbing Occasionally
2. Physical Requirement - Fine Motor Skills (pinching, gripping, etc) Occasionally
3. Physical Requirement - Hearing Frequently
4. Physical Requirement - Pushing/pulling Occasionally
5. Physical Requirement - Reaching Occasionally
6. Physical Requirement - Sitting Frequently
7. Physical Requirement - Standing Occasionally
8. Physical Requirement - Stooping/crouching/kneeling/crawling Occasionally
9. Physical Requirement - Talking Frequently
10. Physical Requirement - Tasting/smelling Occasionally
11. Physical Requirement - Walking Frequently
12. Physical Requirement - Near Vision Occasionally
13. Physical Requirement - Far Vision Occasionally
14. Physical Requirement - Color Discrimination Occasionally
15. Physical Requirement - Use of keyboard, mouse and/or computer equipment Constantly
16. Physical Requirement - Lift up to 35 pounds without assistance Occasionally
17. Physical Requirement - Lift more than 35 pounds without assistance Occasionally
18. Occupational Exposure/Risk Potential - Inside office environment Applicable
19. Occupational Exposure/Risk Potential - Confined areas Applicable
internal/external
I have reviewed the qualifications, physical requirements and occupational exposure/risk potential for this position and wish to apply