Patient Access Rep II Healthclub Admin Contingent Days

Patient Access Rep II Healthclub Admin Contingent Days

Requirements

• High school diploma, associate degree in related area desired.
• Two to three years of progressively more responsible experience in patient access, hospital registration or related area.
• Advanced knowledge of third party payers requirements, reimbursements and copayments/deductible collections etc.

Responsibilities

• Functions as a resource to Patient Access Representative I.
• Provides training and orientation on department methods, procedures and policies.
• Provides input for establishing departmental policies and procedures.
• Resolves complex eligibility or insurance verification problems through contacts with patient or patient family, state or government agencies, other hospital departments and third party payers.
• Assists Financial Counselor with financial counseling services to help patients in identifying and obtaining payment sources.
• Participates in bed management as defined in operating unit policies and procedures.
• Verifies insurance coverage and benefits, obtains and analyzes necessary authorizations and referrals, and calculates estimated patient liability.
• Reviews, monitors, and reconciles patient accounts to ensure accurate bill production.
• Ensures compliance with third party payer requirements.
• Registers and schedules patients for health services ensuring appropriateness of setting for services provided.
• Explains appropriate forms to patient and family and ensures that necessary consent, regulatory forms, and MSP questionnaire (if applicable) are completed correctly and that patient signatures are obtained.
• Obtains accurate insurance, medical and demographic data to admit or pre-admit patients to the health facility.
• Determines patient co-pay/deductibles and collects payment as outlined in hospital policies.
• Assists patients without medical insurance coverage in completing medical assistance applications and/or making payment arrangement and cash collections.
• Coordinates scheduling of all tests and/or services utilizing current clinical guidelines.
• Develops liaison relationship between patient and health facility by answering patients questions regarding health facility policies and billing procedures.
• Completes telephone registrations as appropriate.
• Resolves bill holds in a timely manner to ensure completion within 5-day bill hold reconciles and corrects any rejected transactions on user specific Transmission, Control and Errors (TCE) reports.
• Assists and participates in special projects as assigned.
• Communicates clinical, financial, and administrative information.
• Performs duties of Lead as requested.
• Performs other duties as assigned.

Preferred Qualifications

• Associate degree in related area desired.