Patient Access Representative

POSITION SUMMARY:

The Patient Access Representative will facilitate all components of the patients’ entrance into the practice. This may include scheduling, registration, benefit verification, pre-certification, and financial clearance. The Patient Access Representative will be responsible for ensuring that the most accurate patient data is obtained and populated into the patient record. This team member must have an exceptional attention to detail and maintain knowledge and competence with insurance carriers, healthcare guidelines as well as federal, state and accreditation agencies.

ESSENTIAL RESPONSIBILITIES: To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation.

Patient Interaction

• Answers calls for multiple areas in efficient and effective manner using standard greetings for opening of call, content of call and closure of call.
• Ensures accuracy in answering questions and assisting customer with requests to meet their needs.
• Demonstrate exceptional customer service and patient focus to make each encounter extraordinary.
• Verify and accurately capture patient demographics, insurance, and appropriate medical information.
• Schedule appointments using appropriate electronic system while following appropriate protocols for clinic/area, including prioritizing patient’s health concerns according to the department’s urgency.
• Ensure that patient questions and problems are resolved efficiently, effectively, and expeditiously within appropriate area of knowledge.
• Provide information to patients and callers regarding appointment, date, time, location, clinic guidelines, parking, etc.
• Captures customer information and document using messaging system to clinic staff and/or providers.
• Schedules appointments in electronic systems using guidelines for area/department including prioritizing patients' health problems according to their urgency while making safe and effective decisions. May include referrals, follow-up on overdue well visits, or overdue vaccinations.
• Updating patient files and appointment information accurately
• Communicating information and important details to other medical care staff
• Contacting insurance companies regarding coverage, preapprovals, billing, and other issues
• Processing payments from patients and handling billing issues between patients and insurance companies
• Managing various types of paperwork and other clerical duties

Other Responsibilities

• Maintain strict confidentiality; adheres to all OSHA, HIPAA, and other federal, state, and local guidelines/regulations.
• Demonstrate dedication to the mission, vision, values, and goals of the organization.
• Regular and reliable attendance including attending monthly staff meetings.
• Perform other duties as assigned

KNOWLEDGE AND SKILLS: The requirements listed below are representative of the knowledge, skills and/or abilities required.

Education and/or Experience: High School diploma or GED required. Minimum one (1) year of customer service experience, healthcare experience preferred.

Supervisory Responsibilities: None

Computer Skills / Technical Knowledge: Proficient in the use of Microsoft Office Suite and familiarity of various EMR systems. General knowledge of computer applications for the frequent use of electronic mail, word processing, data entry, spreadsheets, graphics, etc.

Mathematical Skills: Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, decimals, and percentages. Ability to understand and identify statistical trend analysis. Ability to identify numerical trends and variances for financial analysis.

Language Skills: Ability to understand, read, write, and speak English. Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, safety data sheets (SDS) or governmental regulations. Ability to effectively present information, respond to questions and professionally interact with managers, employees, patients, vendors, the public, and diverse groups of people, particularly difficult/resistant patient populations and multiple types of providers in a variety of settings.

Reasoning Ability: Must be able to apply principles of logical thinking to define problems, collect pertinent data, establish facts, draw valid conclusions, and initiate appropriate course of action.

Other Qualifications: The ability to think critically, solve complex challenges and productively manage conflict. Must be able to handle multiple, simultaneous tasks effectively and efficiently. Strong verbal and written communication skills required. Must be detail oriented and organized with the ability to perform duties under pressure, prioritize workload, and timely meet deadlines. Must have the aptitude and ability to self-direct work.

PHYSICAL AND MENTAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential job responsibilities.

While performing the duties of this job, the employee is occasionally required to stand; sit; walk for extended periods of time; use hands to touch, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, bend, crouch, or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 15 pounds. Required specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

While performing the duties of this job, the employee must be able to work in a fast-paced, sometimes stressful, customer service, health care-oriented environment, perform duties under pressure and meet deadlines in a timely manner. The employee must work as part of a team, complete assignments independently and take instructions from others.

WORK ENVIRONMENT: Work environment characteristics described here are representative of those that an employee may encounter while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job responsibilities.

Works in well-lit, ventilated and climate-controlled medical office environment where routine equipment is used; some equipment has moving mechanical parts. May be exposed to hot and cold temperatures.

Must possess reliable transportation, a valid driver’s license and maintain an acceptable driving record in accordance with company policy.

Limited overnight travel expectations.