Patient Access Associate I - ED & Admitting - 24hrs

About the role

Under general supervision, coordinates and performs a variety of administrative, registration and financial support duties for the unit/department. Utilizes judgment to interpret department policies to resolve routine inquiries/problems. Identifies opportunities for process improvements.

Responsibilities

• Provides general receptionist, secretarial support or Health Unit Coordinator functions.
• Performs a variety of administrative support activities in support of the unit operations.
• Responds with tact and discretion to the needs of patients and families.
• Maintains privacy and confidentiality by abiding by HIPPA Policies.
• Registration: Collects and enters accurate demographic, guarantor and financial data for Emergency Department, Inpatient and Outpatient cases and Physician Practice Office appointments.
• Verifies all required insurance and billing information and uses the proper payer plan codes.
• Generates all necessary forms for patient visit and obtains patient/parent/legal guardian signature for Assignment/Authorization and consent.
• Pre-registers patients adhering to standard department procedure.
• Makes corrections and updates patient information in ADT systems as necessary.
• Documents thorough, clear, explanatory notes regarding reasons for incomplete information at time of registration and documents insurance verification method along with response.
• Documents concise and understandable comments regarding patient or guarantor interaction, efforts to collect co-payments and referrals to Financial Counseling.
• Follows-up on open items to resolve outstanding issues and complete the file.
• Reviews and works assigned work queues for registration information to ensure that accounts are accurate at time of visit and or billing.
• Scheduling: Schedule routine appointments either in person or via telephone.
• Creates/inputs routine department provider appointments.
• May schedule/coordinate appointments with other areas of the hospital.
• Works directly with DCF to obtain appropriate signatures/legal guardian information.
• Front Office (Check-In): Arrives patients for their appointment in the ADT system.
• Verifies demographic and insurance information at time of arrival (including securing patient financial liability at time of service).
• Check out process including scheduling or rescheduling future appointments.
• Answers telephone and triage calls for the department.
• Ensures all consent and privacy forms are signed.
• Works directly with DCF to obtain appropriate signatures/legal guardian information.
• Enters routine to complex patient charges into billing system for physician or care provider visits, according to protocol.
• Attempts to collect the patient liability, co-payment on all accounts at the designated collection point.
• Other front office duties as required.
• Financial: Verifies insurance plans using the various methods available such as, RTE, web-based, & telecommunications.
• Investigates patient insurance coverage, obtains referrals, and manages process to maximize payment from both commercial and managed care plans.
• Refers patients/ families to DSS and/or Financial Counselor for assistance.
• Post payments in ADT system, provide receipts.
• Identifies those patients without adequate insurance coverage.
• Demonstrates knowledge of the age-related differences and needs of patients in appropriate, specific populations from neonate through adolescence and applies them to practice.
• Demonstrates cultural sensitivity in all interactions with patients/families.
• Demonstrates support for the mission, values and goals of the organization through behaviors that are consistent with the CT Children’s standards.

  Qualifications

  • Education and/or Experience Required: High School Diploma, GED, or a higher level of education that would require the completion of high school, is required. Experience Required: 3-5 years directly related customer service experience required.
  • Education and/or Experience Preferred: Education Preferred: Associate's degree preferred. Experience Preferred: Healthcare experience preferred.
  • Knowledge, Skills and Abilities: Knowledge of: Working knowledge of MS Word and Excel. ADT systems and Insurance Verification systems (EPIC preferred). Knowledge of Managed Care, referral/pre-certification/authorization process. HIPAA Skills: Computer, typing, data entry. Excellent telephone and communication skills. Ability to: Handle a fast-paced, high-volume environment. Work in a team environment alongside multiple disciplines.