Patient Access Representative II

• Job Summary
• Responsible for performing scheduling, pre-certification, benefit verification and pre-certification. Requires fast response to customer needs, independent judgement, ingenuity and initiative in utilization of computers and other equipment. Works with staff and understand appropriate scheduling processes and how processes affect ancillary departments. Conducts patient and guarantor interviews for inpatient, outpatient and emergency care registration. Explains hospital policies and financial responsibilities and obtains all required signatures. Ensure that all demographic and financial data is obtained and entered into the EPIC system in an accurate and timely manner. Ensures that pre-certification and/or authorization is obtained to comply with insurance company policies. Determines estimated patient financial responsibility through verified insurance benefits, co-pays and deductibles and calculates estimated self-pay portions to be collected at time of registration.
  
  

Controls the main line of communication with physicians, nursing, clinical staff, non-clinical staff and Patient Access Department to ensure appropriate patient scheduling for proper entry into and through the health care system. Performs all other duties as assigned by the management team.

• Job Requirements
• Minimum Education Requirement
• Associates degree preferred.
• Minimum Experience Requirement
• 2-3 years experience in the healthcare industry required. Working knowledge of medical terminology, ICD-10 and CPT Coding. Knowledge of patient access services and the overall effect on the revenue cycle, a thorough understanding of government and commercial insurance plans, payor networks, and government resources. Demonstrates effective communication with a customer and simplifying complex information, experience working in a role that requires prioritization of multiple critical priorities while ensuring quality and achievement of performance metrics. Strong customer service experience, meets departmental POS collections expectation on an average basis. Ability to communicate effectively both orally and in writing. Ability to build productive internal and external working relationships. Advanced problem solving skills and the ability to work collaboratively with other departments to resolve issues with innovative solutions. Moderate analytic skills, strong organizational skills and attention to detail, EPIC knowledge is preferred. Maintains average of 95% registration accuracy rate and is able to perform job duties of two or more Patient Access positions.
• Minimum License Requirement
• Certified Revenue Cycle Associate (CRCA) or Certified Healthcare Assess Associate (CHAA) certification eligible.
• Physical Requirement/Working Conditions
• External applicants, as well as position incumbents who become disabled, must be able to perform the essential functions, either unaided or with the assistance of a reasonable accommodation to be determined on a case by case basis. This position is required to work holidays, weekends and fill in for vacation coverage.