Health Access Rep Diem

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advance technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical Group is made up of more than 250 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization.  As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed minimum pay reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Minimum Pay:

Position Overview

ESSENTIAL FUNCTIONS

• Follows all payor requirements for both in/out of network insurance plans and identifies needs for referrals and precertification either electronically or by telephone according to department procedures and guidelines. Performs verification of benefits on all patient encounters. Audits chart for accuracy.
• Follows computer system, internet-based insurance applications, department operational procedures and training guidelines to obtain accurate demographic, diagnosis, authorizations/referrals and insurance information on each registration.
• Demonstrates service excellence by professionally assisting patients and customers with the utmost respect in a friendly caring manner.
• Works collaboratively with other departments, physicians, physician office staff to obtain essential registration information such as insurance authorization, referrals, diagnosis and scripts, to secure financial reimbursement and customer/patient satisfaction.
• Complies with department procedures and regulatory guidelines for Medicare Secondary Payer, Medicare Necessity Regulations, Collection of co-pay/deposit, Advance Beneficiary Notice, Advance Directives, and Patients’ Rights.
• Registers established goal of minimum required patients per employee shift as measured by productivity reports. Correctly identifies a patient according to policy, completes all patient registration types by collecting and entering accurate patient demographics, physician information, insurance information and valid category codes.
• Obtains all necessary signatures. Assures insurance information is verified, and authorization is obtained if not done prior to service, essential registration forms are scanned into Electronic Medical Record, and chart follow up is performed as needed.
• Ascertains and records appropriately the difference between primary care physician, referring physician and attending physician.
• Displays comprehension of identifying participating CH insurance plans and the ability to identify non participating plans.
• Utilizes the Insurance Card Database and/or Insurance Verification guidelines.
• Follows Financial Screening and Self Pay Procedure with regards to referrals for Medicaid and Charity Care.
• Attends all mandatory department meetings.
• Supports and participates in department performance improvement initiatives.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

Frequent physical demands include: Sitting , Standing , Walking , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion

Occasional physical demands include: Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl

Continuous physical demands include: Talk or Hear

Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.

Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Depth Perception, Accurate Hearing

Anticipated Occupational Exposure Risks Include the following: Bloodborne Pathogens , Airborne Communicable Disease , Extreme Noise Levels , Dust/Particulate Matter

Offers are contingent upon successful completion of our onboarding process and pre-employment physical.  Capital Health will require all applicants to have an annual flu vaccine prior to start date, with the exception of individuals with medical and religious exemptions.

For benefit eligible roles, in addition to cash compensation, we provide a comprehensive and highly competitive benefits package, with a variety of physical health, retirement and savings, caregiving, emotional wellbeing, transportation, robust PTO plan, overtime to eligible roles, and other benefits, including "elective" benefits employees may select to best fit the needs and personal situations of our diverse workforce.

The pay rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity.  Bonus and/or incentive eligibility are determined by role and level.

The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare.  Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.