Patient Access Representative

Group Health Cooperative is a member-governed, nonprofit health care system that coordinates care and coverage. Founded in 1947 and based in Seattle, Wash., Group Health and its subsidiary health carriers, Group Health Options, Inc. and KPS Health Plans, serve more than 600,000 residents of Washington and North Idaho.

Successful candidates will demonstrate a high degree of adaptability, productivity, and reliability as well as an ability to work in an ambiguous environment. They will have effective interpersonal, communication, and customer service skills for both face-to-face and telephone interactions with patients, medical staff and team members. Candidates will be positive, open-minded, and focused on continuous improvement. They must be able to learn new processes, procedures and software programs quickly, while demonstrating attention to detail and accuracy in their daily work.

* Perform general patient access and registration duties in EPIC Practice Management, such as, answer telephones, make appointments, process referrals, maintain provider templates and appointment schedules, verify patient demographics and insurance coverage. * Perform general patient account management duties, such as, obtain prior authorization for services, process items in the appropriate work queues to complete registration and enter service capture data. * Ensure patient accounts and coverage structures meet Group Health standards and billing requirements of various payers. * Function as liaison to Patient Financial Services and the Health Plan. * Communicate with external government payers and employers, as necessary. * Work directly with patients on billing related matters and provide fee estimates to patients for Group Health services. * May perform duties related to cash collection and depositing. Demonstrate strong customer service and communication skills. * Adhere to HIPAA and patient confidentiality requirements. May act as the patients' first point of contact with Group Health.

**Education:** Minimum Education Requirements * High School Diploma/GED **Preferred Education** * Vocational School/Certificate Program Vocational training in medical office procedures and billing. Coursework or practical training and experience in ICD-9 and CPT coding. **Knowledge/Skills:** Minimum Knowledge/Skills Requirements * Basic PC skills in MS Windows environment, 10-key and typing (35 WPM). * Customer service skills, the ability to effectively communicate with a diverse customer base, and strong organizational skills. **Preferred Knowledge/Skills** * Familiar with medical terminology. * Knowledge of delivery system business operations processes, including appointing, account intake and verification, cashiering, financial interviewing, referral processing and data entry. * Working knowledge of healthcare insurance practices and billing. * Knowledge of health care payer/insurer types, including state and federal workers compensation, commercial, subrogation, self-insured, Medicare (CMS) and Medicaid (DSHS). * Understanding of Group Health Cooperative insurance products and benefits. * Proven ability to establish credibility and respect with patients. * Proven ability to problem solve and take initiative. * Ability to provide feedback and education to other staff regarding correct procedures. **Experience:** Minimum Experience Requirements * 1 year of experience in a business office of a medical group practice, hospital, insurance company or a large contact center; experience in electronic patient accounting, scheduling or customer information systems. * 2 years (In lieu of 1 yr required above): experience providing excellent customer service in a fast-paced environment **Preferred Experience** * 1 year of experience in processing various types of billing, including workers compensation, subrogation, coordination of benefits, and private/self-pay. * Successful candidates will demonstrate a high degree of adaptability, productivity, and reliability as well as an ability to work independently in an ambiguous environment. * They will have effective interpersonal, communication, and customer service skills for both face-to-face and telephone interactions with patients, medical staff, and team members. * Candidates will be positive, open-minded, and focused on continuous improvement. * They must be able to learn new processes, procedures, and software programs quickly, while demonstrating attention to detail and accuracy in their daily work. * 3 years Additional experience in a patient care setting. Experience with IDX (Phamis) LastWord patient accounting system. * Use of Epic Cadence/Prelude/Resolute or other patient scheduling and accounting systems. * Understanding of Group Health Cooperative billing protocols and cash posting systems. **License/Certifications:** Minimum License/Certifications Requirements * None Required **Preferred License/Certifications** * None Required