Patient Access Representative - HUM Harrison Gastro
Company: St. Joseph Health
Location: Eureka
Posted on: June 6, 2021
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Job Description:
We are looking for a Patient Access Representative for the HUM
Harrison Gastro Department at St. Joseph Heritage Healthcare. Location: Eureka, California Schedule: Full time - 80 Biweekly hours Shift: 8 Hour, Days Job Summary: Under minimal supervision, assists physician and other
professionals in referral requests and patient placement, responds
to all patient inquiries, referral and PCC materials. Correlates
work assignments and daily activities with Supervisor and
Manager. Essential Functions: Assist in the sorting and distribution of referrals within the
department. Responsible for all referral requests (HMO, EPO, PPO and
Caloptima) to outside providers. Check eligibility, enrollment,
benefits, etc. Process referral at authorized level. Educates patient, physician and staff in HMO, PPO and Caloptima
protocols and benefits. Responsible for participation in, Quality Management,
Utilization Management, and Peer Review Committee meetings. May provide on-site support at satellite locations, as
requested. Generate, log and file assigned QM/UM reports within established
deadlines. Identify and communicates through established protocols, the
trends/patterns that adversely impact flow. Generate and track all patient and physician correspondence
related to referrals. Identify and communicate through established protocols,
non-compliance with Utilization guidelines. Completes disability forms for patients, as needed. Responsible for the obtainment of all relevant materials and
information to make informed referral decisions. Timely response and appropriate communication with the SJHH-
Customer Service Department for the quick and complete resolution
of patient issues. Research and initiate resolution of patient complaints, as
appropriate (with in scope of knowledge and certification). Skills: Ability to work independently and self-prioritize workload. Good organizational, documentation and communication skills. Demonstrates dependability. Must be able to work in a fast-paced department and handle
multiple tasks, work with interruptions, and deal effectively with
confidential information. Exhibit courtesy/respect for co-workers; willing to help
co-workers. Bilingual English/Spanish communications skills preferred. Must be able to type 45 WPM, accurately preferred. Minimum Position Qualifications: Education: H.S. Diploma or GED Experience: 1 year of experience in a managed care setting Licenses/Certification: Valid California driver's license Preferred Position Qualifications: Experience: 3 years of experience in a managed care setting Intermediate level of MS Word, Excel, and Windows experience Apply Today! Applicants that meet qualifications will receive a
text with some additional questions from our Modern Hire
system. Mission Heritage Medical Group is one of California's most
respected medical groups. With over 3,000 employees and 75
locations throughout California, including, Northern California,
Orange County, High Desert and Los Angeles County, Mission Heritage
Medical Group has been continually recognized as a leader in
quality, customer service and information technology. This kind of
success is the result of team work, a commitment to excellence and
a strong adherence to the organization's mission, vision and
values. Mission Heritage Medical Group provides equal employment
opportunities (EEO) to all employees and applicants for employment
without regard to race, color, religion, sex, national origin, age,
disability or genetics. In addition to federal law requirements,
Mission Heritage Medical Group complies with applicable state and
local laws governing nondiscrimination in employment in every
location in which the company has facilities. This policy applies
to all terms and conditions of employment, including recruiting,
hiring, placement, promotion, termination, layoff, recall,
transfer, leaves of absence, compensation and training.
Keywords: St. Joseph Health, Redding , Patient Access Representative - HUM Harrison Gastro, Other , Eureka, California
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