Job Description

Summary :

Patient Access Representatives facilitate a welcome and easy access to the facility and are responsible for establishing an encounter for any patient who meets the guidelines for hospital service.

Patient Access staff ensures that all data entry is accurate including demographic and financial information for each account.

Patient Access has numerous procedural requirements including data elements, insurance verification, authorization for services, and collections for all patient portions including prior balances.

Patient Access staff is responsible for the successful financial outcome of all patient services. Patient Access is responsible for ensuring the hospital maintains compliance with Federal regulations, JCAHO, and Department of Health and Hospital compliance standards.

Patient Access communicates directly with patients and families, physicians, nurses, insurance companies and third party payers.

This position requires professional appearance, and behavior, good communication skills and effective organizational skills.

Patient Access representatives require dependability, flexibility, and teamwork.

Responsibilities :

• Accurately inputs all required data elements for scheduling and registration, including patient demographic, financial information, guarantor information, and relevant notes associated with the encounter.
• Verifies insurance eligibility and obtains necessary authorizations for services rendered.
• Calculates and collects the estimated patient portion based on benefits and contract reimbursement as well as prior balances.
• Performs financial assessment for appropriate program assistance.
• Communicates the purpose of and obtains patient / legal guardian signatures on all necessary hospital documents.
• Represents the Patient Access department in a professional, courteous manner at ALL times.
• Required to assist the hospital in the event of an internal or external disaster.
• Supports the flexible needs of the department to accommodate patient volume in all areas of the hospital. This may require assignment to another area of the department, and shift change.
• Supports the department in achieving established performance targets.
• Completes required training as needed and as mandated.
• Maintains the team discipline of following all elements of established standard processes
• Works with HPWT (High Performance Work Teams) to maintain an efficient, clean, and orderly workplace using 5S principles and practices once implemented in the work unit.
• Coordinates, communicates, and assists in monitoring work flow and work tasks necessary to manage fluctuating volumes.
• Provides feedback to the team to help identify educational needs, and mediation needs by reporting IPOs (issues, problems, and opportunities).
• Demonstrates competence to perform assigned responsibilities is a manner that meets the population-specific and developmental needs of the members served by the department.
• Appropriately adapts assigned assessment, treatment, and / or service methods to accommodate the unique physical, psychosocial, cultural, age-specific and other developmental needs of each member served.
• Takes personal responsibility to ensure compliance with all policies, procedures and standards as promulgated by state and federal agencies, the hospital, and other regulatory entities.
• Performs all duties in a manner that protects the confidentiality of patients and does not solicit or disclose any confidential information unless it is necessary in the performance of assigned job duties.
• Performs other duties as assigned.

Requirements :

• High School Diploma or equivalent years of experience required.
• 1 3 years of experience preferred

Last updated : 2024-05-20