Patient Access Representative One

About the Role

A Patient Access Representative will assist in the coordination, prioritization, and completion of front-end patient registration activities, ranging from pre-registration through discharge. The role ensures patient insurance verification is accomplished and all requirements are met.

Key Responsibilities

• Accurately completes patient registrations based on departmental protocols, standards, policies, and procedures, and in compliance with regulatory agencies.
• Calls patients to pre-register or confirm appointments.
• Prioritizes work for optimal reimbursement and to avoid financial risk to both patient and hospital.
• Ensures all insurance requirements are met prior to or on the date of service and informs patients of their financial liability, collecting liability due.
• Identifies patients who require early financial counseling intervention and refers uninsured patients to a financial counselor.
• Assists patients, guarantors, and families with insurance questions professionally and escalates unaddressed insurance benefit concerns to the department Financial Counselor.
• Maintains confidentiality of patient information, employee information, and other information covered by regulations or professional ethics.
• Performs duties in support of the EHC Patient Access Mission Statement.
• Demonstrates ability in time management and handling high patient volumes in a fast-paced setting.
• Maintains thorough understanding of insurance, registration, scheduling, referrals, authorizations, and account follow-up.
• Maintains knowledge of multiple department system applications utilized by Patient Access.
• Familiarizes with and adheres to all state and federal regulations such as EMTALA, CMS, HIPAA, and JCAHO guidelines.
• Effectively communicates identified issues and concerns in a constructive and professional manner.
• Participates in generating ideas and solutions for improvements.
• Responds in a timely and appropriate way to verbal and written requests.
• Accurately searches the database to establish if a patient is new or established.
• Obtains required signatures for release of information in a timely manner, adhering to policy and procedures.
• Completes registration by verifying information and insurance for established patients or entering information for new patients prior to discharge.
• Reconfirms date of birth and legal spelling of patients' names.
• Obtains appropriate signature(s) and scans all appropriate documents (Admission/Registration Agreement, Notice of Privacy Practice, Important Message from Medicare, etc.).
• Scans patient ID and insurance cards.
• Makes every attempt to collect patient liability as appropriate and documents the response if not collected.
• Appropriately distributes registration paperwork according to departmental procedures.
• Schedules procedures/follow-up appointments.
• Communicates hospitals' financial policies to all patients.
• Maintains appropriate monthly assurance accuracy rate as determined by the department.
• Maintains established departmental standards regarding productivity, quality, and collections.

Requirements & Tech Stack

• High school diploma or equivalent.
• Working knowledge of Health Plan coverage types.
• Experience using general office equipment.
• Proven ability to work in a fast-paced, demanding team environment with daily deadlines.
• Excellent interpersonal, verbal, and written communication skills and ability to speak and write effectively at a level appropriate for the job.
• Ability to work well with individuals at all levels of the organization.
• Registration/telephone/call-center; pre-registration/scheduling experience preferred.

Physical Requirements

• Medium Max 25lbs: up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly).
• Lifting 25 lbs max.
• Carrying of objects up to 25 lbs.
• Occasional to frequent standing & walking.
• Occasional sitting.
• Close eye work (computers, typing, reading, writing).
• Physical demands may vary depending on assigned work area and work tasks.

Environmental Factors

• Environmental factors may vary depending on assigned work area and tasks.
• Environmental exposures include, but are not limited to: Blood-borne pathogen exposure, Bio-hazardous waste, Chemicals/gases/fumes/vapors, Communicable diseases, Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work.
• Travel may be required.
• Use of personal protective equipment, including respirators.