Patient Access Representative

General Summary To ensure prompt and efficient access to hospital care, by providing exceptional service to customers during the registration experience. Create a customer focused environment through effective communication with patients and guests.

Accurately collect reimbursement information for clinical care and reimbursement. Coordinates and is responsible for patient registration for the initiation of legal medical record and financial data. Essential Duties and Responsibilities Greets and interviews patient/patient representatives.

Gathers accurate demographic and insurance information to be contained in the medical and financial records. Secures proper admission consent from patient for the authorization to treat, permission to release information to verify and file insurance and guarantee payment of account. Verifies patient insurance information through the electronic verification service utilized by the facility.

Researches any discrepancy between the electronic verification and patient documentation. Prior to finalizing registration. Advises patients of his/her rights as a patient in accordance with Federal, State, and TJC requirements.

Responds to inquiries from patient/patient representative quickly and effectively by actively listening and taking the appropriate action. Discusses confidential information only in appropriate settings. Collects applicable copays.

Secures an escort or directs patient to the appropriate treatment area after completing the patient interview. Completes, accurately and timely the input of patient information. Promptly, scans electronically and collects the proper patient information and insurance information for verification and financial review.

Recognizes registrations that require pre-authorization or pre-certification prior to procedure. Validates that the order is complete with two patient identifiers, a dated signature by the ordering provider, an appropriate diagnosis is indicated for the test being ordered, and check that the correct test is being ordered. Documents pertinent information on patient accounts via notes.

Demonstrates understanding of billing requirements, denials and the importance of proper registration and documentation. Assures hospital compliance with Medicare Secondary Payor (MSP), HIPAA Privacy Standards, Patient Bill of Rights and Responsibilities, Advanced Directives, Consent to Treat, EMTALA, JACHO Requirements. Ensures each patient completes HIPAA acknowledgment and offers financial assistance information.

Communicates in a professional, positive and respectful manner with patients, offices and coworkers. Be able to provide consistent excellent customer services in a variety of situations. Have excellent verbal and written skills.

Produces and distributes patient estimates and issues ABN to the patient, collects any applicable copays or patient cost shares at the time of service. Performs Switchboard duties and coverage. Keeps information organized and accessible, maintains clean/functional work space, works systematically/efficiently, and manages time well.

Meets commitments, works independently, accepts accountability, handles change, sets personal standards, upholds the facility standards for conduct and grooming, stays focused under pressure, and meets attendance/punctuality requirements. Keeps Admission desks and reception areas clean and organized. Job Qualifications Education High school diploma or equivalent required.

Prefer a certificate or diploma from a school specializing in Medical Front Office, CNA and/or Medical Terminology. Work Experience Six months of office and/or call center, customer service or healthcare experience is required. Knowledge of computers and other standard office equipment required.

Certification/License Not applicable. Mental/Physical Requirements Ability to concentrate, pay close attention to detail and perform duties under time restrictions. Normal mental concentration on variable operations for short periods of time and moderate concentration with repetitive operations for long periods of time.

Work involves extensive use of computer with frequent interruptions. Ability to stand, walk, sit and reach. Must be able to assist and transport patients in wheel chairs.

Working Conditions The standard office conditions with more than average noise. Periodic contact with conditions such as fumes, noise, chemicals, hazards, and/or diseases. Ability to work shifts is required.

General Summary

• To ensure prompt and efficient access to hospital care, by providing exceptional service to customers during the registration experience. Create a customer focused environment through effective communication with patients and guests.
  
  Accurately collect reimbursement information for clinical care and reimbursement. Coordinates and is responsible for patient registration for the initiation of legal medical record and financial data.

Essential Duties and Responsibilities

• Greets and interviews patient/patient representatives.

• Gathers accurate demographic and insurance information to be contained in the medical and financial records.

• Secures proper admission consent from patient for the authorization to treat, permission to release information to verify and file insurance and guarantee payment of account.

• Verifies patient insurance information through the electronic verification service utilized by the facility.
  
  Researches any discrepancy between the electronic verification and patient documentation. Prior to finalizing registration.

• Advises patients of his/her rights as a patient in accordance with Federal, State, and TJC requirements.

• Responds to inquiries from patient/patient representative quickly and effectively by actively listening and taking the appropriate action.

• Discusses confidential information only in appropriate settings.

• Collects applicable copays.

• Secures an escort or directs patient to the appropriate treatment area after completing the patient interview.

• Completes, accurately and timely the input of patient information.

• Promptly, scans electronically and collects the proper patient information and insurance information for verification and financial review.

• Recognizes registrations that require pre-authorization or pre-certification prior to procedure. Validates that the order is complete with two patient identifiers, a dated signature by the ordering provider, an appropriate diagnosis is indicated for the test being ordered, and check that the correct test is being ordered.

• Documents pertinent information on patient accounts via notes.

• Demonstrates understanding of billing requirements, denials and the importance of proper registration and documentation.

• Assures hospital compliance with Medicare Secondary Payor (MSP), HIPAA Privacy Standards, Patient Bill of Rights and Responsibilities, Advanced Directives, Consent to Treat, EMTALA, JACHO Requirements. Ensures each patient completes HIPAA acknowledgment and offers financial assistance information.

• Communicates in a professional, positive and respectful manner with patients, offices and coworkers. Be able to provide consistent excellent customer services in a variety of situations. Have excellent verbal and written skills.

• Produces and distributes patient estimates and issues ABN to the patient, collects any applicable copays or patient cost shares at the time of service.

• Performs Switchboard duties and coverage.

• Keeps information organized and accessible, maintains clean/functional work space, works systematically/efficiently, and manages time well.

• Meets commitments, works independently, accepts accountability, handles change, sets personal standards, upholds the facility standards for conduct and grooming, stays focused under pressure, and meets attendance/punctuality requirements.

• Keeps Admission desks and reception areas clean and organized.

Job Qualifications

• Education

• High school diploma or equivalent required.
  
  Prefer a certificate or diploma from a school specializing in Medical Front Office, CNA and/or Medical Terminology.

• Work Experience

• Six months of office and/or call center, customer service or healthcare experience is required. Knowledge of computers and other standard office equipment required.

• Certification/License

• Not applicable.

Mental/Physical Requirements

• Ability to concentrate, pay close attention to detail and perform duties under time restrictions. Normal mental concentration on variable operations for short periods of time and moderate concentration with repetitive operations for long periods of time.
  
  Work involves extensive use of computer with frequent interruptions. Ability to stand, walk, sit and reach. Must be able to assist and transport patients in wheel chairs.

Working Conditions

• The standard office conditions with more than average noise. Periodic contact with conditions such as fumes, noise, chemicals, hazards, and/or diseases. Ability to work shifts is required.