Patient Access Representative

Per Diem

Weekends and Holidays

JOB SUMMARY of PATIENT ACCESS REP:

Under the direction of the Patient Access Manager, the Patient Access Representative is responsible for obtaining and verifying patient demographic information, insurance, and other information for various hospital records. Informs patient of hospital and regulatory policies in regards to patient care and collection practices. Functions as the communication liaison of patient services, as appropriate from Pre-cert to Admission.

ESSENTIAL RESPONSIBILITIES:

• Responsible for front-end revenue cycle management by registration of patients for Emergency, Scheduled Outpatient and Inpatient procedures.
• Requires extensive knowledge of all insurances and demographic information which drives the revenue cycle.
• Responsible for switchboard operations including emergency operations procedures.
• Greets patients, relatives or patient representatives as the communication liaison for patient services and access.
• Responsible for current and new regulatory requirements for state, federal, and commercial payors.
• Responsible for ABN and co-payment collection practices.
• Follows-up on incomplete registrations by contacting physician offices or patient at-home to get complete information.
• Receives inquiries from other facilities regarding patient demographic and insurance information.

SKILLS & ABILITIES:

• Ability to maintain confidentiality concerning patient problems and hospital matters.
• Ability to deal with the public in a courteous, efficient and empathetic manner.
• Ability to plan, organize and direct flow of communications and tasks within job description and responsibility.
• Ability to work calmly and effectively under stressful conditions.
• Ability to concentrate on detailed and repetitive record keeping.
• Ability to type 35 WPM.
• Ability to work effectively with other members of the team.

QUALIFICATIONS:

• Education: High school graduate or equivalent required.
• Experience: 2 years Customer Service experience preferred.
• Knowledge of Healthcare Insurance preferred
• Knowledge of medical terminology preferred.
• Excellent customer service skills required.
• Computer literacy required.

JOB DUTIES/RESPONSIBILITIES:
• Although position has no responsibility for the assessment, treatment or care of patients, demonstrates ability to communicate and interact with patients and customers of all ages.
• Demonstrates knowledge of all department and hospital policies relevant to the performance of their responsibilities.
• Extensive knowledge of all insurance, Medicare, Medicaid, and commercial payors, including demographic information which drives the revenue cycle.
• Coordinates all registrations; pre-registrations, admissions and pre-admissions activities with medical staff, physician offices, patient accounts and all other hospital departments as required to support the operation of all hospital systems.
• Understanding and processing of Advanced Beneficiary Notice (ABN) at registration including the ability to explain the ABN to the patient and obtain the required signature.
• Responsible for informing patient or patient representative of the "Important Message from Medicare" form and obtain the required signature
• Releasing bodies from the morgue.
• Notification of inpatient admissions over the weekend to insurance companies that require notification
in less than 24 hours.
• Prints all forms for patient's chart and send to appropriate area.
• Performs other duties as assigned.