Patient Access Rep II

Description

RESPONSIBILITIES:

• A Patient Access Rep II will assist in the coordination, prioritization and completion of front-end patient registration activities ranging from pre-registration through discharge in the Patient Access Services Department.
• The representative will ensure patient insurance verification is accomplished and all requirements are met.
• Accurately completes patient registrations based on departmental protocols and standards, policies and procedures, and compliance with regulatory agencies.
• Calls patients to pre-register or confirm appointments.
• A Patient Access Rep II 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 and collects liability due.
• Identifies patients who require early financial counseling intervention.
• Ensures all uninsured patients are referred to a financial counselor as appropriate.
• A Patient Access Rep II will also assist patients, guarantors and families with insurance questions in a professional manner and is responsible for escalating any 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.
• Position requires self-motivated individual with demonstrated ability in time management who can handle high patient volumes and fast pace.
• Maintains thorough understanding of insurance, registration, scheduling, referrals, authorizations, and account follow-up.
• Maintains knowledge of multiple department system applications utilized by Patient Access.
• Familiar 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 patient is new or an established patient.
• Obtains required signature for release of information in a timely manner, adhering to policy and procedures.
• Completes registration by verification of information and insurance for established patient or entering information for new patient prior to discharge of patient.
• Reconfirms date of birth and legal spelling of the patients name.
• Obtains appropriate signature(s) and scans all appropriate documents (Admission/Registration Agreement, Notice of Privacy Practice, and 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.
• Call patients to pre-register or confirm appointments.
• Maintains appropriate monthly assurance accuracy rate as determined by the department.
• Maintains established departmental standards regarding productivity, quality, and collections.

MINIMUM QUALIFICATIONS:

• High school diploma or equivalent.
• Must have at least 2 years healthcare related or customer service experience.
• Knowledge of Medicare, Medicaid, and other commercial payers (HMO, PPO) preferred.
• Associate or bachelor degree may be accepted in lieu of experience.
• Certified Healthcare Access Associate (CHAA) preferred.
• Typing skills with a minimum of 35 wpm and good communication skills.

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: Factors affecting environment conditions may vary depending on the 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, Patie