HCA, Hospital Corporation of America PTAC Central Unit Representative Work From Home in San Antonio, Texas
Job Summary – The PTAC Central Unit Representative is responsible for timely and accurate processes associated with some or all of the following:
• Insurance verification
• Insurance Notification
Supervisor – PTAC Central Unit Manager
Supervises – not applicable
Shift: Sun-Wed 10 hour shifts
Duties (included but not limited to):
Duties will be performed by each individual depending on assignment of responsibilities:
• Perform pre-registration and insurance verification within 3-5 days prior to date of service for both inpatient and outpatient services. For notification received with less than 3 days’ advanced notice perform within 24 hours of notification.
• Follow scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information in the approved standard format
• Assign Insurance Plans (IPlan’s) accurately
• Perform electronic insurance eligibility confirmation when applicable and document results
• Complete Medicare Secondary Payor Questionnaire as applicable for retention in imaging system (i.e. OnBase)
• Calculate patient cost share and be prepared to collect via phone or make payment arrangement
• Contact patient via phone (with as much advance notice as possible, preferably 48 hours prior to date of service) to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct patient on where to present at time of appointment
• Receive and record payments from patient for services scheduled.
• Utilize appropriate communication system to facilitate communication with hospital gatekeeper
• Ensure appropriate documentation is entered in standard format on the patient record. This should be performed in the applicable Health Information System (i.e. Meditech) and if necessary any other subsidiary systems if they are not automatically updated.
• Contact physician to resolve issues regarding prior authorization or referral forms
• Research Patient Visit History to ensure compliance with payor specific payment window rules
• Perform insurance verification and pre-certification follow up for prior day’s walk in admissions/registrations and account status changes by assigned facility as per SSC
• Communicates with hospital based Case Manager as necessary to ensure prompt resolution of pre- existing, non-covered, and re-certification issues
• Meets/exceeds performance expectations and completes work within the required time frames
• Implements and follows system downtime procedures when necessary
• Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”
• Other duties as assigned
KNOWLEDGE, SKILLS & ABILITIES
• Communication - communicates clearly and concisely, verbally and in writing. This includes utilizing proper punctuation, correct spelling and the ability to transcribe accurately.
• Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
• Interpersonal skills - able to work effectively with other employees, patients and external parties
• PC skills - demonstrates proficiency in Microsoft Office applications and others as required
• Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems
• Basic skills - demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes, have ability to work quickly and accurately in a fast-paced environment while managing multiple demands, ability to work both independently and collaboratively as a team player, adaptability, analytical and problem solving ability and attention to detail and able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately.
High school diploma or GED required.
One year of related experience required.
PHYSICAL DEMANDS/WORKING CONDITIONS
Requires prolonged sitting/standing, some bending, stooping, walking and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports or other information. Requires lifting papers/boxes and pushing/pulling up to 25 pounds occasionally. Work is performed in an office environment or hospital setting. Work may be stressful at times. Contact may involve dealing with angry or upset people. Staff must remain flexible and available to provide staffing assistance for
any/all disaster or emergency situations.
OSHA CATEGORY –The normal work routine involves no exposure to blood, body fluids, or tissues (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Persons who perform these duties are not called upon as part of their employment to perform or assist in emergency care or first aid, or to be potentially exposed in some other way.
Job: *Admitting Registration Clerical & Scheduling
Title: PTAC Central Unit Representative Work From Home
Location: Texas-San Antonio-Shared Services - San Antonio
Requisition ID: 08949-147090