ED Patient Svcs Representative

About the Role

Functions under the general direction of department leadership in Patient Access. Coordinates patient access for all phases of the revenue cycle from scheduling and registration up to and including referral and denial management.

Responsibilities

• Reconciliation and maintenance of First Net Emergency Department Tracking Board and Hospital ADT system.
• Accurate registration into hospital ADT and/or clinical system during system downtime with monitoring and reconciliation of every patient for accuracy.
• Central resource for all ADT registration and problem resolution during evenings, weekends, and holidays.
• Confirms insurance eligibility, accountable for third-party reimbursement, and coordination of benefits to support a seamless billing process.
• Counsels patients regarding insurance coverage and expected financial liability.
• Collects and records patient payments including co-payments, co-insurance, and deductibles on the day of service.
• Provides a warm greeting for all patients and supports UPMC core values and guiding principles.
• Proper patient identification to start clinical record (utilizing biometrics if applicable).
• Facilitates financial gatekeeping with clinical partners and maintains a close working relationship to ensure open communication regarding alias name changes, information blocks, and behavioral health insurance payors.
• Obtains or updates necessary demographic and insurance-related information.
• Performs timely patient interviews and registrations for services at the bedside, generates and completes all applicable forms, and obtains necessary signatures for consent to treat and financial responsibility while adhering to HIPAA regulations.
• Remains calm and professional in stressful situations while prioritizing work activities.
• Anticipates and responds to inquiries from patients, visitors, hospital personnel, and government agencies under all conditions.

Requirements

• Completion of high school graduate or equivalent.
• 2 years' experience in a healthcare or 1 year in a medical/billing/fiscal setting, or 6 months in a UPMC Patient Access position preferred.
• Medical terminology, third-party healthcare coverage experience, and a strong understanding of managed care regulations are preferred.
• Experience with personal computer-based applications, office equipment, and proficient typing skills.
• Excellent interpersonal, written, and verbal communication skills.
• Initiative to work productively with minimal supervision.
• Able to work well under pressure.

Licensure, Certifications, and Clearances

• Act 34