What are the responsibilities and job description for the Patient Access Rep II position at ECU Health?
Position Summary
Responsible for creating the first impression of the organization's services to patients and families and other external customers. Essential duties may include scheduling, registration and insurance verification for both outpatient and inpatient services by collecting proper demographic information and securing authorizations for procedures. Acts as the primary liaison for patients receiving professional and hospital services at ECU Health.
Responsibilities
Interacts with physicians and/or physicians' office staff to secure diagnosis, procedure details or authorization information as needed.
Receives scheduling requests for procedures utilizing Cadence to schedule based on physician orders
Obtains diagnosis and procedure information from patient, clinical department or physician offices to perform ABN/Medical Necessity screening, as required.
Works closely with physician office staff and utilization review/case management to coordinate certification process (initial authorization and extended stay authorization).
Resolves any insurance verification and financial clearance issue prior to or during hospital service; this involves contacting insurance/third party payers to resolve eligibility and benefits issues and to initiate insurance appeals if necessary.
Interviews patients face-to-face or by phone to obtain scheduling and/or registration information.
Handles incoming calls and exercises judgment in scheduling caller for correct procedure in appropriate service area; receives telephone requests to schedule from patients, physicians, physicians' office staff, etc.
Collects complete and accurate demographic, financial, and clinical information to properly enter into the electronic health record to complete a hospital registration.
Provides timely and thorough information to all other providers & customers that utilize the patient data.
Reviews registration account for accuracy to ensure the hospital is properly reimbursed.
Obtains signatures on consent forms, HIPAA, Observation Notice, Important Message from Medicare and other important forms as required within the Hospital's policies.
Explains financial obligations, negotiates deposits and payment arrangements with patients and or guarantors and attempt to collect patient copayments or other uninsured balances on accounts.
Verify insurance benefits using the electronic insurance eligibility application (Passport), internet application or telephone calls to insurance carriers, Obtain authorizations and pre-certification for applicable visits.
Ensures that all required documents including consent forms, precertification documents, benefits information and insurance card copies are scanned into the correct patient EHR.
Cross trained to perform other functions within the division as assigned.
Serves as a coach to new registration staff as assigned.
Gives feedback to management on issues that impact departmental workflow.
Provide focused training for individuals identified by the Team Lead and/or Supervisor.
Ensure that scheduling / registration reports and work queues are being addressed by staff.
Assist management with special projects and reports.
Serve in a lead capacity for departmental goals and initiatives.
Other duties as assigned.
Minimum Requirements
High School or Equivalent (GED) or higher is required.
Associate Degree: preferred
Bachelors Degree: preferred
1 to 2 years of Registration and/or Billing experience within a healthcare setting is required
3 to 5 years - customer service experience is required
Required
Excellent communication (both written and oral), detail orientation, organization, and multitasking skills required
Insurance Verification experience
Preferred
Experience with EPIC and medical office workflows
Experience with Microsoft Office/PC-based applications (Outlook, Word and Excel)
ECU Health
About ECU Health Duplin Hospital
ECU Health Duplin Hospital is an 81-bed facility located in Kenansville, North Carolina. The 15-bed emergency department serves approximately 25,000 patients per year. In addition to providing general medical and surgical services, ECU Health Duplin Hospital offers chemotherapy and other cancer infusion interventions and has earned national designation as a Primary Stroke Center.
General Statement
It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.
Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.
We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant’s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.
Responsible for creating the first impression of the organization's services to patients and families and other external customers. Essential duties may include scheduling, registration and insurance verification for both outpatient and inpatient services by collecting proper demographic information and securing authorizations for procedures. Acts as the primary liaison for patients receiving professional and hospital services at ECU Health.
Responsibilities
Interacts with physicians and/or physicians' office staff to secure diagnosis, procedure details or authorization information as needed.
Receives scheduling requests for procedures utilizing Cadence to schedule based on physician orders
Obtains diagnosis and procedure information from patient, clinical department or physician offices to perform ABN/Medical Necessity screening, as required.
Works closely with physician office staff and utilization review/case management to coordinate certification process (initial authorization and extended stay authorization).
Resolves any insurance verification and financial clearance issue prior to or during hospital service; this involves contacting insurance/third party payers to resolve eligibility and benefits issues and to initiate insurance appeals if necessary.
Interviews patients face-to-face or by phone to obtain scheduling and/or registration information.
Handles incoming calls and exercises judgment in scheduling caller for correct procedure in appropriate service area; receives telephone requests to schedule from patients, physicians, physicians' office staff, etc.
Collects complete and accurate demographic, financial, and clinical information to properly enter into the electronic health record to complete a hospital registration.
Provides timely and thorough information to all other providers & customers that utilize the patient data.
Reviews registration account for accuracy to ensure the hospital is properly reimbursed.
Obtains signatures on consent forms, HIPAA, Observation Notice, Important Message from Medicare and other important forms as required within the Hospital's policies.
Explains financial obligations, negotiates deposits and payment arrangements with patients and or guarantors and attempt to collect patient copayments or other uninsured balances on accounts.
Verify insurance benefits using the electronic insurance eligibility application (Passport), internet application or telephone calls to insurance carriers, Obtain authorizations and pre-certification for applicable visits.
Ensures that all required documents including consent forms, precertification documents, benefits information and insurance card copies are scanned into the correct patient EHR.
Cross trained to perform other functions within the division as assigned.
Serves as a coach to new registration staff as assigned.
Gives feedback to management on issues that impact departmental workflow.
Provide focused training for individuals identified by the Team Lead and/or Supervisor.
Ensure that scheduling / registration reports and work queues are being addressed by staff.
Assist management with special projects and reports.
Serve in a lead capacity for departmental goals and initiatives.
Other duties as assigned.
Minimum Requirements
High School or Equivalent (GED) or higher is required.
Associate Degree: preferred
Bachelors Degree: preferred
1 to 2 years of Registration and/or Billing experience within a healthcare setting is required
3 to 5 years - customer service experience is required
Required
Excellent communication (both written and oral), detail orientation, organization, and multitasking skills required
Insurance Verification experience
Preferred
Experience with EPIC and medical office workflows
Experience with Microsoft Office/PC-based applications (Outlook, Word and Excel)
ECU Health
About ECU Health Duplin Hospital
ECU Health Duplin Hospital is an 81-bed facility located in Kenansville, North Carolina. The 15-bed emergency department serves approximately 25,000 patients per year. In addition to providing general medical and surgical services, ECU Health Duplin Hospital offers chemotherapy and other cancer infusion interventions and has earned national designation as a Primary Stroke Center.
General Statement
It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.
Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.
We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant’s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.