ESTES PARK HEALTH COMPANY DESCRIPTION:

Estes Park Health exists to make a positive difference to the health and well-being of all we serve. Located about 90 miles northwest of Denver, at 7,522 feet above sea level, Estes Park Health sits in the heart of the Rocky Mountains. As a gateway to Rocky Mountain National Park, the adventurous lifestyle Estes Park supplies open endless outdoor opportunities for our staff. We promote a healthy work-life balance to give our staff the time to enjoy the “playground” that is Colorado.

From pediatrics to geriatrics, Estes Park Health supplies a full spectrum of care for our friends, neighbors, and visitors in the entire Estes Park Valley and Rocky Mountain National Park. Today, over 18,000 patients—residents and visitors alike—see our health care teams for both outpatient and inpatient services.

SUMMARY:

The Patient Access Service Center Representative (PASC) is responsible for the centralized call center functions to include customer service, registering and scheduling patients for multiple hospital-based service lines including but not limited to admissions, surgical procedures and diagnostic testing throughout Estes Park Health utilizing a computerized scheduling EMR System and multiple software applications. The PASC will assist patients with pre-authorization needs and cost estimates for services. The employee will have interactions with all levels of staff and management, physicians, patients, and families to obtain demographic and medical information required to properly schedule and register services and ensure accurate billing and reimbursement. The employee will use judgement and established protocols to adjust schedules and accommodate special requests from internal and external customers.

ESSENTIAL DUTIES:

• All Staff Members perform in accordance with Estes Park Health’s Mission, Vision and Values
• Gather and document all pertinent patient demographic information required to support accurate scheduling of clinical services and accurate billing and reimbursement for services rendered.
• Accurately schedules patient appointments utilizing electronic medical record (EMR) Epic System Work Queues, Referrals, Phone or Fax.
• Adheres to standard operating procedures during EMR or other system downtimes.
• Answers multi-line ACD telephone system utilizing courteous and professional telephone techniques and interpersonal skills to establish and maintain rapport with patients, physicians/office personnel and various hospital personnel, while maintaining patient confidentiality.
• Performs insurance verification for benefit eligibility obtained by running Real Time Eligibility (RTE).
• Obtains insurance authorizations through payor websites and/or phone call for all outpatient and inpatient procedures requiring a pre-authorization. Assures regulatory and compliance requirements following local payor coverage determinations by running medical necessity checks to ensure codes meet guidelines when needed and completes necessary ABN for non-covered services and works with ordering physician to obtain revised order if necessary.
• Notifies patient of insurance benefit verification, estimated self-pay balances, and payment plan programs and options available. Establishes payment plan arrangements in accordance with established policies or makes referrals to Financial Counselors to assess eligibility for other payment sources.
• Collects identified patient self-pay balances at the time of registration.
• Captures accurate insurance/benefit information to be able to run a financial estimate for a patient’s scheduled procedure. Refers patients for financial counseling, when applicable.
• Financially clears scheduled patients for hospital services once all verification and pre-authorization processes are completed.
• Expected to meet all goals set by the department management to include, but not limited to productivity, accuracy, work queue assignments, collections, and customer satisfaction.
• Performs all related job duties as assigned; may have additional department specific duties assigned as deemed necessary by management to meet business needs.

KNOWLEDGE, SKILLS, & ABILITIES:

• Medical terminology and basic anatomy/physiology
• Proficient in the use of computers and Microsoft Office software applications
• Excellent problem solving, analytical skills, highly organized and ability to multi-task
• Working knowledge of HIPAA and protected health information
• Ability to work independently, emotionally mature, and able to function effectively when dealing with difficult situations
• Ability to be flexible and manage change and ability to work with speed and accuracy while completing multiple projects is required.
• Excellent communication and interpersonal skills on the telephone and in person.
• Must be able to demonstrate knowledge of billing requirements and proper documentation of.
• Must be able to meet tight time frames and have excellent customer service skills.
• Participates in committees as assigned
• Demonstrates mastery of hospital wide scheduling and registration
• Required to handle complex scheduling, authorizations and complete pre-registration processes
• Must possess detailed understanding and knowledge of insurance guidelines and protocols, the components of full verification, and payor information and requirements
• Demonstrate proficiency in medical terminology, including diagnoses and surgical operative procedures

POSITION REQUIREMENTS:

• High School diploma or GED required
• Associate degree or above may be considered in lieu of experience requirement
• 2-3 years of medical office experience, or 4 years of customer service experience, required
• Computer knowledge and skills required
• Must successfully complete/pass EPIC training/competency tests
• Thorough knowledge of third-party insurance coverage and reimbursement methodologies, preferred
• Ability to speak English for a business setting; bilingual a plus
• Customer focused
• Medical terminology
• Basic anatomy/physiology

PAY RANGE:

$19.33 - $26.29 per hour

BENEFITS:

We offer a full range of benefits to fit your needs and family for full time and part time employees!

All employees are enrolled in a Money Purchase Pension Plan 401(a) which replaces Social Security contributions. You control the investments on-line yourself or with you financial advisor to help it grow. We also offer a 457(b) plan for you to ad additional funds to your investments.

Medical – Choose from a HSA or PPO medical plan with pre-tax spending accounts.
Dental – An affordable all-inclusive services plan. No need to choose from 2 or 3 options.
Vision – Just for you or your whole family.
Paid Time Off – Personal and sick leave immediately available as accrued each pay period.
Medical Transport – Add MASA as a supplemental for both Air and Ground usable in all 50 states.
Accident and Critical Illness – For those unexpected life issues that may happen. Cash payouts to you.
Term Life and AD&D INS. – Free to full and part time employees.
Voluntary Life Ins. – Additional coverage for you to purchase for yourself, spouse and or children.
Short Term Disability – 2 levels to purchase for your needs.
Long Term Disability – Free to you while employed.
Employee Assistance Program – A comprehensive program for you and your family member which includes a national provider network for counseling services, life balance services, legal and financial services

For more information about this opportunity e-mail questions to HR@eph.org.

Equal Opportunity Employer: In compliance with federal law, including the provisions of Title VII of the Civil Rights Act of 1964, Section 503 and 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990, EPH does not discriminate on the basis of race, sex, religion, color, national or ethnic origin, age, disability, or military service in its administration of policies, programs, activities or employment. In addition, EPH does not discriminate on the basis of sexual orientation or gender identity.

The descriptions above are listed as is at the time of posting and could change as needed at any time in accordance with state, local and federal laws.