Admissions & Collections Clerk - CHC-Pediatrics

Full Job Description

Under general supervision, incumbents will be responsible for enrolling patients in the Family PACT program, Hospital Presumptive Eligibility, and Sliding Fee Discount Programs, ensuring referrals are accurately added to visits, completing registration Claim Edit and Charge Review Work queues, processing IEHP transfer forms for patients not assigned to RUHS, assisting patients with questions related to follow-up visits, prescription issues, coverage information, and required paperwork; checking in on patients, verifying eligibility, updating patient and insurance information, outreach to all patients to schedule appointments, verifying appointments, collection of nominal fees due at time of service, cashing out, answering phones, making copies, and faxing; performing other related duties as required.

The following professional experience is preferred:
- Bilingual
- Knowledge of medical coverages including Medicare, Medi-Cal, Managed Care Plans, and Medicare Advantage plans
- Customer service experience/skills

Work Schedule: 5/40, Monday through Friday from 8:30am to 5:00pm

Meet the Team!Riverside University Health System provides a wide range of primary and specialty care services across 13 Community Health Centers (CHCs) throughout Riverside County.

As federally qualified health centers, the CHCs operate on a sliding fee scale to ensure that some of the county’s most vulnerable populations receive the care they need.

Whether it’s preventive care, chronic disease management, Express Care, Mobile Health, or integrated specialty and behavioral health services, our teams are made up of dedicated healthcare professionals who are passionate about making a difference.

If you’re committed to delivering compassionate care and eager to join a team that truly values community, connection, and making a meaningful difference, RUHS is the place for you!

Learn more about our Community Health Centers by visiting www.ruhealth.org

Requirements

•Review patient personal data to evaluate the patient's eligibility for medical assistance programs using formal medical program guidelines.

•Review patient insurance forms and cards to ensure completeness and accuracy as required by assistance programs and private insurance carriers for billing and payment.

•Evaluate possible assistance eligibility and refer patients to Medi-Cal and MISP as appropriate.

•Contact patient's medical insurance carrier to obtain authorization for treatment and verify eligibility and coverage.

•Assist patients with scheduling hospital or clinic appointments in person or over the phone.

•Pre-register scheduled services during scheduling process or any time prior to receiving services as directed by supervisor or manager.

•Receive and record payments for medical treatment from patients.

•Record payment information on patient payment receipt and log this information on the appropriate forms.

•Complete patient medical information or MISP Share of Cost Forms; attach cash payment receipt to ensure reimbursement from medical assistance program.

•Refer patients with problem accounts to Patient Accounts for review of account status.

•Receive required information from patients and complete medical forms to ensure accuracy of patient data.

•Collect and prepare receipt for monies.

•Register patients for medical services such as emergency treatment and non-emergency walk-in treatment.

•Serve as a resource person for patient registration in the Riverside University Health System (RUHS) clinics.

•Assist in conducting outpatient registration audits and participate in RUHS quality assurance initiatives.

•Reconcile daily charge sheets of patient visits to ensure that charges for healthcare services rendered are captured in a timely manner.

Qualifications

OPTION I

Experience: Two years of clerical experience, including three months performing admissions, collections or billing functions in a hospital, mental health or other healthcare setting.

(Completion of 18 semester or 27 quarter units from an accredited college or university in secretarial sciences, office practices, business education, or a closely related field to the assignment may substitute for one year of the non-specialized experience.)

OPTION II

Experience: Two years of clerical experience, including three months performing admissions, collections or billing functions in a hospital, mental health or other healthcare setting.

(Completion of 360 hours of training from a recognized occupational training program in secretarial sciences, business education or a closely related field to the assignment may substitute for one year of the non-specialized experience.)

OPTION III

Experience: Two years of clerical experience, including three months performing admissions, collections or billing functions in a hospital, mental health or other healthcare setting.

(Six months of clerical experience in a medical setting may substitute for one year of the non-specialized experience.)

Physical Requirements:

1. Sitting at a computer for long periods of time
2. Standing, walking intermittently. May need to walk to different departments or stand while assisting patients.
3. Reaching, bending, to access files, supplies, or office equipment.
4. Typing, using a mouse, handling documents, scanning IDs, operating the phone system
5. Reading screens, forms, ID cards, and small print accurately
6. Listening to patients in person or over the phone, sometimes in noisy environments.
7. Explanation of State Funded Programs to applicants.
8. Must speak clearly, professionally with patients, sometimes in stressful situations.
9. Ability to remain calm, empathetic when dealing with sick, upset, or confused patients.
10. Handling file boxes, office supplies, or small equipment

ALL OPTIONS

Knowledge of: Modern office procedures, including the preparation of reports and correspondence and filing; the operation of standard office equipment and medical terminology.

Ability to: Perform complete registration cycle, including collection of monies; effectively interview to obtain personal, family and financial information; gather, record and evaluate data in the admission of hospital patients and the handling of patient accounts; maintain accurate records; apply the rules and regulations pertaining to the admission of patients, private and public medical insurance, billing procedures, credit authorizations, and payment agreements; work with very ill, injured and emotionally distressed people.

Additional Information

For questions regarding this recruitment, contact Raven Padilla at rpadilla@rivco.org or 951/955-0780. Please allow 1-2 business days for response to general inquiries.