Patient Access Representative I

Patient Access Representative I

Requirements

• Excellent customer service skills are required
• Ability to receive and express detailed information through oral and written communications
• Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors
• Knowledge of insurance plans and benefits
• Computer literate and able to operate in multiple applications such as Microsoft Office
• Minimum typing skills of 35-40 wpm (certified typing test results required)
• Requires eye-hand coordination and manual dexterity
• Requires the use of office equipment, such as computer terminals, telephone, and copiers
• Knowledge of medical terminology
• Able to handle multiple tasks simultaneously
• Ability to work weekends, Friday, Saturday, and Sunday. Must be flexible and able to work flex and staggered shifts
• Requires substantial amount of walking

Responsibilities

• OBTAINS/CONFIRMS AND ENTERS/UPDATES DEMOGRAPHIC AND INSURANCE INFORMATION FOR ALL PATIENTS
• Consistently confirms, enters, and/or updates all required demographic data on patient and guarantor in registration system(s) on a daily basis to achieve maximum payment
• Secures and/or explains copies of insurance card(s), forms of ID, and signature(s) on all required forms and scans them into the appropriate imaging documentation system
• Consistently completes the Medicare Secondary Payer (MSP) questionnaire, if applicable
• Discusses Advanced Directives with patients and obtains a copy for the patient’s record, if available
• Reviews all other regulatory forms and information with the patient, such as Notice of Privacy Practice and Billing information
• Verifies insurance using Real Time Eligibility, Payer Website, or phone number to determine coordination of benefits and obtains authorization and/or referrals as required
• Follows procedures to accurately identify a patient and apply the patient identification bracelet, if applicable
• Registers patients during downtime following downtime procedures and enters data into registration system immediately upon system availability
• Performs Service Recovery as needed at the point of service with patients and visitors
• VERIFIES INSURANCE COVERAGE, SCREENS PATIENT FOR POTENTIAL FUNDING SOURCES, AND SETS EXPECTATIONS FOR REIMBURSEMENT OF SERVICES
• Verifies financial information to determine insurance coordination of benefits, pre-certification/prior-authorization requirements by contacting the insurance company or through other verifying technology
• Informs self-pay patients of prepayment requirements or screens for funding sources
• Prepares estimate of procedures, calculates advance payment requirements, informs patient of acceptable payment arrangements on previous and current balances
• Refers potentially eligible patients to contract eligibility vendor(s) to pursue funding reimbursement
• Coordinates with clinical areas to establish patient financial expectations and assist in the resolution of revenue cycle issues
• Maintains up to date knowledge, requirements, and skills to perform daily duties and meet key performance metrics for the facility, unit, and payers
• COLLECTS, POSTS, AND RECONCILES ALL PAYMENTS FROM PATIENTS
• Consistently collects patient payments and provides receipt accurately completing all required fields
• Calls patient prior to date of service to inform them of their expected financial liability
• Coordinates with appropriate providers when payment is unable to be collected from the patient
• Accurately posts all payments on system
• Accurately reconciles receipts with cash collected and completes required balancing forms at the end of their shift
• PERFORMS OTHER POSITION APPROPRIATE DUTIES AS REQUIRED IN A COMPETENT, PROFESSIONAL, AND COURTEOUS MANNER

Preferred Qualifications

• Patient Access Certification (preferred)
• One (1) year relevant experience in a medical office or hospital preferred