Company Overview
Vail Health, formerly known as Vail Valley Medical Center, is a nonprofit community healthcare system dedicated to serving patients and visitors from around the world. Locally managed and overseen by a volunteer board of directors, Vail Health operates a 56-bed hospital accredited by the Joint Commission. Our 24/7 emergency department in Vail is a Level III Trauma Center, equipped with a nearby helipad for critical medical transports.
Vail Health offers a broad range of services and multiple access points, including Beaver Creek Medical Center, urgent care clinics in Vail, Avon, and Eagle, our Edwards medical campus, Eagle Healthcare Center, and a multispecialty health center in Dillon. Howard Head Sports Medicine provides physical therapy across 10 locations, collaborating closely with world-renowned orthopedic partners at The Steadman Clinic and Vail-Summit Orthopaedics. Additionally, Vail Health’s Shaw Cancer Center and Sonnenalp Breast Center are the region’s only fully accredited cancer treatment and comprehensive breast centers.
About the Opportunity
This position is responsible for patient registration, admissions, and insurance-related tasks. The Patient Access/HIM Representative also manages the assembly, maintenance, and storage of medical records.
Key Responsibilities
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Patient Registration & Admissions:
- Registers patients and completes all related tasks, including explaining and obtaining necessary consents and authorizations.
- Collects required financial documents, such as patient responsibility statements and co-payments.
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Patient Communication & Customer Service:
- Assists patients in accessing care by responding to phone calls, emails, and inquiries in a timely and professional manner.
- Provides clear and accurate information, following up with relevant departments when necessary.
- Resolves non-clinical questions within scope while delivering exceptional customer service in person and over the phone.
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Documentation & Compliance:
- Conducts ongoing documentation audits for medical necessity, plans of care, and other payer requirements, including Medicare.
- Ensures compliance with Centers for Medicare & Medicaid Services (CMS) guidelines by verifying medical necessity, communicating coverage and eligibility details, and managing Advance Beneficiary Notices (ABNs).
- Completes Medicare Secondary Payer Questionnaires per CMS standards.
- Maintains organized and secure medical records, scanning and verifying completeness.
- Notifies physicians of documentation delinquencies and informs clinical management of nursing documentation deficiencies.
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Administrative & Office Support:
- Manages, organizes, and responds to incoming office correspondence (mail, email, faxes, phone calls).
- Maintains front desk supply inventory, ensuring cost-effective departmental spending.
- Assists management with month-end closing procedures, including preparing and reviewing reports.
- Aids clinical staff in gathering and coordinating data for medical record reviews, such as blood usage and surgery complications.
- Processes medical record requests, verifying appropriate releases before fulfilling them.
- Prepares records for external auditors, ensuring compliance and keeping leadership informed of project status.
- Adheres to HIPAA, EMTALA, and Joint Commission regulations, providing necessary patient literature.
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Additional Duties:
- Ensures compliance with organizational values and Just Culture principles.
- Performs other assigned tasks at both departmental and organizational levels.
- Maintains strict HIPAA compliance in all duties.
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