What are the responsibilities and job description for the Patient Access Representative Senior - Emergency Department position at Virginia Commonwealth University Health Systems?
The Patient Access Representative Senior handles all business functions in an assigned clinical department area to include reception, scheduling, and registering patients for appointments and/or procedures. This position also secures the appropriate patient information; ensures that registration data is correct and accurate; validates insurance eligibility, ensuring accurate data entry; collects co-pays, and supports financial counseling and financial clearance, as necessary.
The Patient Access Representative Senior also supports in training new team members and has advanced knowledge in role responsibilities.
Essential JobStatements
Greet Patients/Answer Telephone
Provides exceptional customer service by welcoming patients and visitors in a friendly, professional, and respectful manner.Ensures individuals are respected and informed, communicating clearly and effectively, andutilizingappropriate languageresources as needed.Assistswith traffic flow in and out of the clinic as needed.Addresses patient needs promptly, and maintains a courteous, professional toneat all times.Serves as anesalationand support team member for the Patient AccessReprentativeTeam.
Co-payment Collection & Registration Data
Collects all patient co-payments and deposits accurately perpayer, following department guidelines.Verifies and updates registration data, including demographic and insurance information. Copies and records insurance information per department standards. Follows department policies for cash handling, including cash reconciliation and deposit preparation.
Referral Management
Verifies insuranceVerifiesinsurance coverage and understands requirements for HMO, managed care, government and private plans. Secures required referrals/authorizations and links them correctly in the referral module. Obtains needed referrals and authorizations before scheduled procedures, tests,injectionsand surgeries.Demonstrates an advanced knowledge of understanding HMO/managed care requirements and clearly communicates them to patients and providers.Provides pre-payment guidance for self-paypatients and offers financial assistance. Prepares cost estimates, explains paymentexpectationsanddocumentsall interactions in the patient account.
Appointment Scheduling, Lab & Test Order Entry
Correctly schedulesclinic appointments throughthemedical records software/communication platform. Transcribesphysician orders accurately and completely (i.e.lab test, ancillary test) andrecords them in theappropriate system(s)according to the physician's instructions and VCUHS policy. Coordinatesthe collection of pre-operative testing and paperwork, whereappropriate.
Patient Record/Verify Registration Data
Maintainsproficiencyin all aspects of patient medical record keeping in an organized manner.Assistsin preparation of the chart before the patient visits. If applicable,assists in breakingdown the chart at the completion of the patient's visit. Ensures that all patients arrived in the appointment scheduling system before the end of the appointment day. Whereappropriate, appointments are documented as "no-shows" or cancellations before the end of the appointment day. Obtains signatures and completes the required forms including those from managed care and other insurance plans.
E-Documents, Management and Scanning
Obtains and scans allappropriate patientmedical documentation.
Training & Development
Supports inthe coaching,developmentand training of new PAR employees.
Miscellaneous Responsibilities
Notifies supervisor of issues involving violation of VCUHS policies or procedures.Performs other duties as assigned and/orparticipatesin special projects to support the mission of VCUHS and department.
Patient Population: N/A
Employment Qualifications
Education Required:High School Diploma or equivalent
Education Preferred:Associates orBachelor's Degree in Accounting, Finance, Business Administration, HealthcareAdministrationor closely related field from an accredited program.
Licensing/ Certification
Licensure Required:N/A
Licensure Preferred:N/A
Certification Required: N/A
Certification Preferred:N/A
Minimum Qualifications
Yearsand TypeofRequiredExperience:Minimum of one (1) yearof VCUHS experience with patient scheduling/registration.
Other Knowledge,Skillsand Abilities Required:Delivers high quality and consistentcustomer service skills. Abilityto cross-cover all PatientAccess functions within the department and/or clinic.Functions in a self-directed manner toaccomplishroutine activities.Ability to effectively orient and trainnew hires to servicearea.
Depending on the assigned area,mayberequiredto work off-shifts and/orweekendand holidays.
Other Knowledge,Skillsand AbilitiesPreferred:N/A
Working Conditions: Periods of high stress and fluctuating workloads may occur.General office environment. May be exposed to human blood and other potentially infectious materials. *May have periods of constant interruptions.
*Individuals in this positionare required toexercise universal precautions, use personal protective equipment and devices, andlearnthe policies concerning infection control.
Physical Requirements
Physical Demands: Lifting/ Carrying (0-50 lbs.), Push/ Pull (0-50 lbs.),Stoop, Kneel, Squat, Crawling, Climbing, Balance, Bending
Work Position: Sitting, Walking, Standing
Additional Physical Requirements/ Hazards
Physical Requirements: Manual dexterity (eye/hand coordination), Perform shift work,Hear alarms/telephone/tape recorder, Repetitive arm/hand movements
Hazards: N/A
Mental/Sensory -Emotional
Mental/Sensory: Strong Recall, Reasoning, Problem Solving, Hearing, Speak Clearly, Write Legibly, Reading, Logical Thinking
Emotional: Fast paceenvironment, Able to Handle Multiple Priorities, Frequent and Intense Customer Interactions, Able to Adapt to Frequent Change
EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.
VCU Health System Authority (VCU Health) complies with applicable civil rights laws and does not discriminate on the basis of race, sex, color, national origin, religion, sexual orientation, gender identity or expression, age, political affiliation, disabilities, marital status, veteran status, residence, financial status, or any other manner prohibited by law.