Patient Access Representative

About the Role

This position is responsible for performing registration, scheduling, order entry, and reception functions, potentially floating to various admitting sites within the health system. The role expedites healthcare access by accurately gathering demographic, sponsorship, insurance, clinical, financial, and statistical information. It also ensures reimbursement through insurance eligibility verification, authorization, collection of patient financial obligations, and accurate charge order entry, aiming to make the admission process comfortable and pleasant for patients and their families.

Key Responsibilities

• Accurately gather demographic, sponsorship, insurance, clinical, financial, and statistical information from various sources (patients, families, physicians, agencies, etc.).
• Ensure reimbursement for services by verifying insurance eligibility/benefits and obtaining insurance authorization.
• Identify and collect patient financial obligations.
• Perform accurate charge order entry.
• Interact with patients of all ages, their families, physicians, and other healthcare providers with professionalism and diplomacy.
• Decrease accounts receivables by adhering to established guidelines, regulations, policies, and procedures during registration.
• Obtain and accurately enter demographic, clinical, and financial information into the computer system.
• Explain and obtain signatures on admission, clinical, and financial forms.
• Collect accident information.
• Identify all insurance payer sources and their order sequence.
• Verify insurance eligibility and obtain necessary notifications.
• Process charge order entries.
• Determine estimated costs for services.
• Identify and collect patient financial obligations (co-payments, co-insurance, deductibles).
• Document all collected information in a timely manner and according to department requirements.
• Explore patient financial needs and refer to appropriate assistance agencies when applicable.
• Perform scheduling, order entry, and reception functions.
• Assist in the completion of departmental tasks.
• Solve problems following established company guidelines.

Requirements & Tech Stack

• Professionalism and diplomacy during stressful situations.
• Ability to anticipate customer needs, deal with the unexpected, establish priorities, and adjust performance style.
• Ability to deal with the sight of various injuries, procedures, and the stress associated with the environment.
• Working knowledge of health care insurance, including accurately documenting subscriber information, determining payer order sequence, and obtaining notifications.
• Ability to ensure patient information is secured and meets confidentiality compliance standards set by The Joint Commission and HIPAA.
• Knowledge of governmental programs billing requirements.
• Ability to identify patient financial obligations and follow standard operating procedures for point-of-service collections.
• Skills to perform order entry.
• Above average computer application skills.
• Ability to follow verbal and written instructions.
• Scheduling skills adaptable to a fast-paced environment with heavy physician/office staff interaction.
• Ability to be flexible and adapt to different admitting department locations.
• Ability to prioritize/multitask in a fast-paced environment.
• Windows Operating systems
• SMS InVision (preferred)
• Internet
• SMS IMS Document Imaging (preferred)
• Microsoft Office Suite (including Outlook, PowerPoint, Excel, Teams, and Word)

Qualifications

• Ability to read, write, speak, and understand English sufficiently to perform job duties safely and effectively.
• High School Diploma or GED preferred.
• Six months of admitting, medical claims processing, professional office experience, and/or customer service experience with financial interaction.
• One year of experience preferred.
• This position does not provide patient care.