Patient Account Representative, Infusion Care - Full-Time/Days (8hr)

Purpose Statement / Position Summary

This position requires the full understanding and active participation in fulfilling the mission of Orange Coast Medical Center. It is expected that the employee demonstrate behavior consistent with our core values: Integrity, Accountability, Best Practices, Compassion and Synergy. The employee shall support Saddleback Medical Center's strategic plan and participate in and advocate performance improvement/patient safety activities.

The Patient Account Representative oversees the billing, insurance verification, eligibility coverage and authorizations to ensure reimbursement in a timely manner. In addition, this position is responsible for the processing of new orders, file management, scheduling of patients, report distribution, computer system utilization, and interaction with patients, physicians, and other hospital personnel. The Patient Account Representative is accountable for maintenance of patient records that apply to the Ambulatory Infusion Center and order entry of scheduled or emergent in patients.  This position will record maintenance including but is not limited to filing of the patient's folder, uploading patient medical records to our system, downloading patient medical records for check out or sends out to other facilities, sending reports to the patient or physician's offices as requested.  This incumbent will also prepare requests for treatment for the physicians and the Infusion Center clinical team. 

Essential Functions and Responsibilities of the Job

1. Maintains Service Excellence with patients, visitors, and other staff members.  Maintains a neat, organized work environment according to specific work- related supplies and reference material locations. Collects and compiles accurate information for hospital records and for timely reimbursement. 
2. Demonstrates expertise in scheduling and registering clients; verifies and updates patient information in Cadence and/or Epic in a timely and accurate manner.
3. Evaluates incoming information received (either by FAX, mail, courier, patient or other customers) and properly distributes or acts upon the information received in a timely and efficient manner.  When processing orders, follows up for incomplete orders, unclear orders or doctor's request to call patient.   
4. Provides verbal or written instructions and education for patient or significant others as needed and as appropriate.
5. Ensures HIPAA compliance on every patient by identifying patient charts with 2 patient identifiers prior to proceeding with output of information.
6. Ensures and obtains correct current eligibility, benefit coverage and authorizations to secure patient accounts. 
7. Prioritizes and coordinates job duties to maximize the department's efficiency, monitors work queues for account follow up and bill release.  Collects and posts patient payments, including deposits, co-pays, deductibles and/or co-insurance accurately.  Documents pertinent information in the referral/auth cert/hospital account note fields.  Maintains effective patient flow when placing same day patient orders, inputs orders correctly according to the prescription and does so in an efficient and timely manner. 
8. Attends meetings as required.  Responds appropriately and promptly to department/management and customer requests for information or other actions.
9. Utilizes equipment appropriately for its intended use, takes measures to identify equipment that needs repair or replacement, following department specific protocols for calling service and documenting such calls.
10. Ability to be at work and be on time.
11. Ability to follow company policies, procedures and directives.
12. Ability to interact in a positive and constructive manner.
13. Ability to prioritize and multitask.

Essential Job Outcomes

1. Demonstrates and maintains Service Excellence with patients, visitors, and other staff members
2. Demonstrates expertise in scheduling and registering clients; verifies and updates patient information in Cadence and/or Epic in a timely and accurate manner
3. Ensures and obtains correct current eligibility, benefit coverage and authorizations to secure patient accounts   
4. Provides verbal or written instructions and education for patient or significant others as needed and as appropriate.
5. Ensures HIPAA compliance on every patient by identifying patient charts with 2 patient identifiers prior to proceeding with output of information.
6. Responds appropriately and promptly to department/management and customer requests for information or other actions.
7. Maintains customer satisfaction with patients, visitors and other staff members.  Answers phone expediently using department specific phone etiquette, helps patients with requests or other information to order as needed.  Demonstrates excellent communication skills in person and over the phone with internal and external customers and Infusion Center Team.
8. "Other duties as assigned"

Experience

• One- year experience scheduling associated experience preferred.
• Knowledge and experience with insurance authorization/pre-certification/billing.
• Knowledge of medical terminology and outpatient department experience preferred.
• Proficient in computer functions, data entry and windows platform. 

Education

• High School graduate or equivalent preferred