Patient Access Representative

About the Role

Responsible for accurately registering patients in EMR including validating patient information, verification of insurance coverage, collection of required payments and ensuring the patient's experience is best in class. Relies on established guidelines to accomplish tasks. Works under close supervision.

Key Responsibilities

• Customer Service
• Patients are courteously and appropriately advised of the collection and billing procedures and anticipated charges so as to assist patients in their understanding their liability and responsibility regarding their payment.
• All patients/families are courteously welcomed and greeted to the clinic.
• Questions & concerns from patients and/or family members are answered/addressed in an appropriate manner.
• Patients are informed of their rights and Advance Directives upon request.
• Patient and insurance information is accurately obtained and edited as necessary in the clinic's computer system.
• Accurately and efficiently registers patients in Epic; monitors and manages the flow of patients through the clinic utilizing initiative to ensure the patient experience is best in class.
• Monitors patient schedules and reviews accounts to determine the patient's financial responsibility on account balance and arranges payment plans to collect.
• Assists patients with access to government and community resources to enhance their access to health care services.
• Works closely with physicians, nurse practitioners and nursing staff to ensure that referrals to other providers/services/facilities are completed in accordance with payor requirements in a timely manner.
• Facilitates the patient's access to information including but not limited to MyChart access.
• Accurately updates patient records as needed.
• Accurately enters patient charges as necessary.
• Patient Flow
• Documentation related to patient referrals is accurately processed.
• Patient appointments are scheduled and rescheduled appropriately.
• A variety of clerical duties (answer telephone calls, retrieve medical records, records data, type memorandums, etc.) are efficiently completed in a timely and efficient manner.
• Current patient charts/files and appropriate information are accurately filed.
• Payor Regulations
• Claim edits and denials are researched and discrepancies resolved within 2 days of notification.
• All information for completing the billing process, including charge information from the physician is researched and discrepancies resolved within 2 days of receipt.
• Charges are keyed and batches processed daily, and bank/deposit summary is prepared immediately after balancing payment to receipts.
• Diagnosis and procedures codes are reviewed for accuracy and data is entered into the system at point of service.
• Patient payments for services rendered are verified and collected from patient 100% of the time.
• Account balances are verified, and the outstanding balance collected from patients and the daily cash fund reconciled daily.
• A general knowledge of the health plans, including co-pays, deductibles and co-insurance is maintained.
• Manages cash in accordance with established policies and procedures to ensure that payments are accurately credited to the patients' accounts and cash is maintained in a secure manner.
• Meets site collection goals.
• Other Duties as Assigned
• Act as a backup for others in the clinic as needed.
• Actively supports clinic, hospital and health system initiatives related to improvement in the day-to-day operations.
• May provide training and orientation for other Team Members when assigned.
• Other duties as assigned.

Requirements & Tech Stack

• EMR
• Epic
• MyChart

Qualifications

• Experience: 6 months experience in a customer service/front desk role or a graduate of a front office/medical office program.
• A Bachelor's degree may substitute for experience.
• Education: High School Diploma or Equivalent
• Special Skills:
• Professional demeanor
• Excellent customer service skills
• Ability to multi-task
• Critical thinking
• Demonstrated computer literacy
• Ability to learn and demonstrate proficiency in Epic during the introductory period.