Patient Access Representative II (Full Time)

Summary/Objective

The Patient Access Representative II is responsible for performing all admitting procedures for patients presenting to the Emergency Room and assisting the Patient Access Manager with duties assigned.

Required Education And Experience

• High School diploma or GED.
• Must be efficient with keyboarding and computer applications.
• One (2) year of experience in healthcare financial counseling.
• One (2) year of experience in a hospital or medical office setting.
• Knowledge of insurance processing.
  
  

Essential Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

• Monitors and promotes compliance with facility policies, workplace safety, positive employee relations, teamwork, mutual respect, and effective communication.
• Responds to concerns and/or complaints from patients, the public, medical staff, subordinates, and/or other hospital employees pertaining to assigned areas in order to maintain positive customer relations.
• Interviews incoming patients or representatives and enters information required for admission into the health information system.
• Obtains required signatures from patient and/or representative for consent of care and any other required documents per hospital policy and protocols. Documents how consent was obtained or not obtained from responsible parties.
• Enters, records, stores, and maintains information in written and electronic form.
• Interview patient or representative to obtain and record individual and/or company insurance responsible for payment of the bill.
• Explains hospital regulations, such as visiting hours and payment of accounts.
• Provide a smooth flow of patients through the admitting area/ER, directing or escorting patients as necessary to the appropriate department.
• Understand the functional status and physical needs of patients, staff, and visitors to the hospital and assist in those needs.
• Maintain a working knowledge of community services and resources available to all patients. Refer patients as necessary to the appropriate agency or department.
• Records all emergency room patients seen on the electronic ER log related to each account.
• Accepts payments and issues receipts, collects co-payments and deductibles, and reconciles petty cash drawer at the end of each shift.
• Process telephone communications in an efficient and courteous manner for patients, physicians, the general public, and hospital staff.
• Pages for medical staff, disaster, and emergency codes as required by policy. Pages should be done in a clear, distinct, and audible voice.
• Run a daily registration quality report before the end of each shift to check the accuracy of registrations and make corrections as necessary.
• Controls visitor access to the hospital after hours, clears any after-hours visitors with the Charge Nurse, and issues visitor passes as appropriate.
• Foster high levels of customer service and release only appropriate patient information while ensuring HIPAA compliance is followed. Refers all other medical information releases to HIM for processing.
• Ensures all patient information is safeguarded and kept confidential according to prescribed policies and procedures.
• Analyze information and evaluate results to choose the best solutions available and solve problems as they arise.
• Develop constructive and cooperative working relationships with others; ensure the flow of communication within the department.
• Interviews, correspond with, and counsels the patient and/ or patient’s family regarding information relative to insurance, employment, and financial ability to pay.
• Verifies insurance benefits prior to admission for all planned admissions and as soon as reasonably possible after admission for all emergencies.
• Coordinates the pre-certification process between hospital and physician offices to ensure that all required procedures and surgery pre-certifications are completed in a timely manner.
• Initiates pre-certification process for Emergency Medicaid patients who require CT/MRI procedures.
• Facilitates training of new team members in addition to cross training other admission personnel for coverage as necessary.
• Demonstrates extensive knowledge of duties and job functions.
• Serve as key support resource to staff.
• Provides guidance and direction to staff regarding workflow, systems, and patient registration processes Troubleshoots and reports issues as needed to manager.
• Monitors staff attendance in their assigned area:
• Assist with monthly Patient Access departmental schedule.
• Ensures daily shift(s) coverage.
• Receives call for staff call-outs.
• Secures shift coverage in cases of illness and emergencies.
• Records, tracks, and identifies patterns of excessive absenteeism and tardiness.
• Responsible for filling shifts if a shift is uncovered regardless of time or day of shift.
• Other duties as assigned by Patient Access Manager.
  

Supervisory Responsibility

This position has limited supervisory responsibilities.

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, copiers, filing cabinets, and fax machines.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to perform the essential functions of this job successfully.

While performing the duties of this job, the employee is regularly required to talk or hear. This is primarily a sedentary role; however, some filing is required. This would require the ability to lift files, open filing cabinets, and bend or stand as necessary.

Position Type/Expected Hours Of Work

This is a full-time position. The employee must be available during the “core” work hours of 7:00 am to 3:30 pm and must work 40 hours each week to maintain full-time status. Occasional overtime may be required as job duties demand

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee of the job. Duties, responsibilities, and activities may change at any time with or without notice.