Patient Access Specialist - Hospice per diem - SJ (8010)
Franciscan Health Systems - University Place, WA

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Job Summary:

This job is responsible for the performing the full range of patient access support activities (e.g. financial, registration, scheduling and administrative) in preparation for patients referred to the Hospice and Palliative Medicine to receive available services in accordance with internal standards/guidelines and applicable regulatory requirements. Patient access functions include, but are not limited to: referral intake, insurance eligibility verification, pre-authorization and certification, coordinating PT/OT/SLP with outside agencies, scheduling for RN/CNA/SW/Comfort Therapy staff, and coordinating triage to cover urgent patient visits (in the absence of primary RN).

Essential Duties:
  • Performs all technical activities for processing referrals to hospice and palliative medicine; obtains necessary documents to complete referral information, and reviews to make sure that all documentation is accurate and complete; ensures that all data is entered correctly into manual and automated system(s) in accordance with established procedures; processes and documents referral cancellations; maintains referral documents and forwards to medical records as required.
  • Evaluates benefits and eligibility, and coordinates reimbursement from all payor sources; contacts payor sources to verify insurance benefits and eligibility on all patient accounts; obtains prior authorization for hospice services, changes in level of care or additional services as necessary; tracks pending DSHS benefits and follows up as necessary; facilitates the processing of charity care applications; communicates accurate reimbursement information to interested parties in a timely and appropriate manner.
  • Enters, reviews, maintains and updates information in Hospice information system(s) (e.g. Suncoast) and patient files with respect to demographics, insurance, referral/admission status, location and team assignments; notifies appropriate entities (e.g. DSHS) of admissions, deaths, physician changes, diagnoses and/or demographic information as required.
  • Contacts referred patients/families to schedule admission and coordinates related scheduling activities in accordance with established procedures; obtains signed consents and related forms as required; schedules actual admission, and notifies and assigns clinical staff (e.g. liaison RN) to all hospitalized patients.
  • Maintains and revises current daily/weekly/monthly staff schedules for assigned disciplines (e.g. RNs, CNAs, Social Workers, etc); schedules clinical staff based on productivity standards, consulting with management when additional staff is needed to meet needs or when scheduled staffing exceeds needs; maintains daily schedule for admission/flex/per-diem RNs; consults with management in covering absences, placing clinical staff on standby or in cutting per-diem staff.
  • Contacts patients to schedule and confirm routine visits as requested; records cancellations and reschedules as necessary.
  • Enters data regarding admissions, level of care changes, deaths, and discharges in automated system(s) and produces reports for distribution to appropriate departments/agencies; notifies insurance case managers of status changes as required.
  • Prepares initial MD Certification of Terminal Illness for signature of the primary MD and Medical Director; tracks certifications for timely return, updates automated systems and forwards to Medical Records.
  • Researches, enters and maintains required data on new MDs into automated system; verifies that MD licensing is current.
  • Identifies opportunities for, and participates in, performance improvement activities.

  • High school diploma or equivalent (GED) is required.
  • Successful completion of an accredited medical terminology course(s), or equivalent on-the-job training.
  • Two years of progressively responsible work experience in patient scheduling/registration, insurance verification, financial counseling or related function,

  • OR any combination of education and experience that would demonstrate the capability to perform the duties of the position.

  • Certified Healthcare Access Associate (CHAA) required within 6 months of hire.

Additional Responsibilities:
  • Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times.
  • Adheres to and exhibits our core values:
    Reverence: Having a profound spirit of awe and respect for all creation, shaping relationships to self, to one another and to God and acknowledging that we hold in trust all that has been given to us.
    Integrity: Moral wholeness, soundness, uprightness, honesty and sincerity as a basis of trustworthiness.
    Compassion: Feeling with others, being one with others in their sorrows and joys, rooted in the sense of solidarity as members of the human community.
    Excellence: Outstanding achievement, merit, virtue; continually surpassing standards to achieve/maintain quality.
  • Maintains confidentiality and protects sensitive data at all times.
  • Adheres to organizational and department specific safety standards and guidelines.
  • Works collaboratively and supports efforts of team members.
  • Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community.
Catholic Health Initiatives and its organizations are Equal Opportunity Employers

Job Administrative and Clerical
Primary Location WA-University Place-Sjmc Hospice & Ltc Pharmacy
* Shift PRN
* Scheduled Hours per 2-week Pay Period 0
* Weekends Required Occasional
* Status PRN

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St. Francis himself may have hailed from Italy, but his followers look after the health of the residents of the South Puget Sound area...