Patient Access Representative III

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Pay Range:

$19.71 - $25.62

Scheduled Weekly Hours:

40

Position Overview

SUMMARY:

Fully trained across all registration areas and able to perform all registration functions independently. Registers patients accurately, efficiently, and professionally to ensure database integrity and facilitate claims processing. Applies financial screening guidelines to ensure collectable accounts. Utilizes standards, guidelines, and written procedures for performing registration functions.

MINIMUM REQUIREMENTS:

Education:    High school diploma or equivalency.
Experience:    One year Patient Access experience. Acquired knowledge of various areas within Patient Access environment. Medical terminology and medical insurance knowledge preferred.
Knowledge and Skills:    Excellent verbal and written communication skills. Strong interpersonal skills.
Special Training:    Proficient computer skills.
Mental, Behavioral and Emotional Abilities:    Ability to work independently and as a team. Maintain composure in high pressure or fast-paced environment.
 

ESSENTIAL FUNCTIONS:

• Works in all registration areas within Patient Access in order to provide coverage for paid time off, leave of absence and unanticipated staffing gaps.

• Demonstrates ability to independently manage all assigned responsibilities.

• Expert in identifying participating Capital Health insurance plans and ability to identify non-par plans.

• Follows computer system and department operational procedures and training guidelines to obtain accurate demographic, diagnosis, and insurance information on each registration.

• Proficient in registering patients quickly and accurately, exceeding the productive levels of a Patient Access Rep II. Correctly identify a patient according to policy, complete all patient registration types by collecting and entering accurate patient demographics, physician information, insurance information, and valid registration-specific codes. Obtains all necessary signatures. Assures insurance information is verified, and authorization is obtained if not done prior to the service. Essential registration forms are scanned into EMR, and chart follow-up is performed.

• Presents forms and obtains signatures using approved scripts.

• Complies with department procedures and regulatory guidelines for Medicare Secondary Payer, Medicare Medical Necessity, Advance Beneficiary Notice, Advance Directives, and Patients’ Rights forms

• Follows payer requirements for authorization, pre-authorization, referrals, coordination of benefits forms, and in-network verification according to department procedures and the Insurance Card Database and Insurance Verification guidelines.

• Follows Financial Screening and Self Pay Procedure with regards to referrals for Medicaid and Charity Care.

• Supports department performance improvement initiatives.

• Assists with accurate data collection in support of quality performance improvement initiatives.

• Attends all mandatory department meetings.

• Performs other duties as needed.

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

• Frequent physical demands include: Sitting , Standing , Walking , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion

• Occasional physical demands include: Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl

• Cont