ACCESS MANAGEMENT REP/PRE-ADM

Overview

Tri-City Medical Center has served San Diego County’s coastal communities of Carlsbad, Oceanside and Vista, as well as the surrounding region for more than 60 years and is one of the largest employers in North San Diego County. Tri-City is administered by the Tri-City Healthcare District, a California Hospital District. As a full-service acute care public hospital with over 500 physicians practicing in over 60 specialties, Tri-City is vital to the well-being of our community and serves as a healthcare safety net for many of our citizens. The hospital has received a Gold Seal of Approval® from the Joint Commission showcasing a commitment to safe and effective patient care for the residents of the community. 

Tri-City Medical Center prides itself on being the home to leading orthopedic, spine and cardiovascular health services while also specializing in world-class robotic surgery, cancer and emergency care. Tri-City’s Emergency Department is there for your loved ones in their time of need and is highly regarded for our heart attack and stroke treatment programs. When minutes matter Tri-City is your source for quality compassionate care close to home. Tri-City partners with over 90 local non-profit and community organizations as part of our COASTAL Commitment initiative. Together we are helping tackle some of our communities’ pressing health and social needs.

Position Summary:  

Interviews patient or representative to obtain necessary personal and financial information.  Prepares patient record and needed demographics to pertinent departments.

 

Major Position Responsibilities:

The position characteristics reflect the most important duties, responsibilities and competencies considered necessary to perform the essential functions of the job in a fully competent manner. They should not be considered as a detailed description of all the work requirements of the position. The characteristics of the position and standards of performance may be changed by TCMC with or without prior notice based on the needs of the organization.

• Maintains a safe, clean working environment, including unit based safety and infection control requirements.
• Collect, confirm and complete patient demographic, employer, financial, emergency contact, insurance, subscriber, and case-specific information, such as referring physician/PCP and diagnosis/chief complaint prior to patient’s scheduled arrival.
• Verifies with OR Department for cancellations and add-ons for next day surgery schedule. Secures all scheduled services for Inpatient Surgery, SDS, and Outpatient Ancillary from scheduling.
• Verifies insurance eligibility, benefits, and authorization prior to service date.  Notifies patient of any financial obligations prior to admit date, and attempts to collect on the liability prior to date of service. 
• Obtain accurate and prompt insurance eligibility by any acceptable means available. This would include insurance internet web sites, Passport/OneSource, 270/271, or by direct telephone contact.  Handles customer services phone calls.
• Pre-admits any surgical add-ons in registration and patient accounting system, with patient notes in system.
• Obtains estimates for surgery costs for patients upon request.
• Explains patient’s financial obligations. Collects cash deposits from patient by phone prior to service date whenever possible. Posts payments upon receipt. 
• Communicate to the patient the hospital’s policy on payment options when significant patient liabilities are identified exceeding $1000.00.
• Coordinates patient information to Express Admit nurse or Bed Placement rep for non-surgical patients who require acute care admission.
• Performs special assigned duties to meet the needs of the department.
• Maintains excellent interpersonal skills in dealing with co-workers, TCMC staff, patients, physicians, and the public.

 

Qualifications:

• One (1) year healthcare insurance verification or billing or third payer authorization experience, required.  
• Requires typing skills of 35 wpm.
• Demonstrates thorough knowledge of different third party payers and their authorization requirements.
• Prefer previous data entry/CRT experience and knowledge of medical terminology.

                                   

Education:

• Requires high school graduate or equivalent. 

 

Each new hire candidate who is offered employment must pass a physical evaluation, urine drug screen and pre-employment background checks before starting work.

 

*Salary/Hourly Wage range based on experience.

 

To protect the health of patients and staff, and to comply with the new State of California mandates, all job offers are contingent on the successful engagement in the TCMC COVID-19 vaccination program (fully vaccinated with documented proof or approved exception/deferral.)

 

TCHD is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with a disability.