Patient Access Representative

About the Role

This position expedites and provides healthcare access through accurate gathering of demographic, sponsorship, guardian, insurance, clinical, financial, and statistical information. Ensures reimbursement for services by verifying insurance eligibility, obtaining authorization, collecting patient financial obligations, and accurate charge order entry. Aims to make the admission process comfortable and pleasant for patients and families.

Key Responsibilities

• Perform all registration, scheduling, order entry, and reception functions.
• Float to various admitting sites within the health system.
• Accurately gather demographic, clinical, and financial information through in-person or telephone interviews.
• Obtain and accurately enter demographic, clinical, 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 payer order sequence.
• Verify insurance eligibility.
• Obtain insurance notification.
• Process charge order entry.
• Determine estimated cost for services rendered.
• Identify and collect patient financial obligation amounts (co-payments, co-insurance, deductibles).
• Document all information collected timely and in accordance with department requirements.
• Explore patient financial needs and refer to appropriate assistance agencies when applicable.
• Assist in completion of departmental tasks.
• Solve problems following established company guidelines.

Requirements & Tech Stack

• Ability to be diplomatic and effectively communicate during stressful situations.
• Ability to anticipate customer needs, deal with the unexpected, establish priorities, investigate and adjust performance style.
• Ability to deal with the sight of various injuries, procedures, and the stress associated with such an environment.
• Working knowledge of health care insurance: Ability to accurately document subscriber information, determine payer order sequence, and obtain notification.
• Ability to ensure all patient information is kept secured, meeting confidentiality compliance standards set by The Joint Commission and HIPAA.
• Knowledge of governmental programs billing requirements.
• Ability to identify the patient's financial obligation and follow standard operating procedures regarding 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/physician office staff interaction.
• Ability to be flexible and adapt to different Admitting department locations.
• Ability to prioritize/multitask in a fast-paced environment.
• Proficient with Microsoft Office Suite (Outlook, PowerPoint, Excel, Teams, Word).
• Ability to use the computer for online learning, accessing forms/policies, and benefits enrollment.
• Does not provide patient care.

Qualifications

• Education: High School Diploma or GED preferred. Ability to read, write, speak, and understand English sufficiently to perform job duties safely and effectively.
• Experience:
• Requires six months of admitting, medical claims processing, professional office experience and/or customer service experience with financial interaction.
• One year preferred.
• Preferred experience with Windows Operating systems, SMS InVision, Internet and SMS IMS Document Imaging.
• License(s): None
• Certification(s): None