Patient Access Rep, I

Description

This position is a part-time, PRN role requiring open availability, including weekdays and weekends. There are no benefits associated with this position. The role focuses on providing patient-focused customer service, performing outpatient and inpatient registration and insurance verification, collecting patient financial liability payments, and ensuring patients meet financial requirements such as Medicare medical necessity, payer pre-certifications, and referrals. Additionally, the position provides general information to hospital users, patients, families, and physician offices.

Responsibilities

• Knows, understands, incorporates, and demonstrates Trinity Health’s Mission, Values, Vision, Actions, and Promise in behaviors, practices, and decisions.
• Researches, collects, and analyzes information to identify opportunities, develop solutions, and lead through resolution.
• Collaborates on performance improvement activities as indicated by outcomes in program efficiency and patient experience.
• Responsible for the distribution of analytical reports.
• Utilizes multiple system applications to perform analysis, create reports, and develop educational materials.
• Incorporates basic knowledge of Trinity Health policies, practices, and processes to ensure quality, confidentiality, and safety.
• Demonstrates knowledge of departmental processes and procedures and ability to acquire new knowledge.
• Researches and compiles information to support ad-hoc operational projects and initiatives.
• Synthesizes and analyzes data, providing detailed summaries including graphical presentations illustrating trends and recommending practical options or solutions.
• Leverages program and operational data to define and demonstrate progress, ROI, and impacts.
• Maintains a working knowledge of applicable federal, state, and local laws/regulations, Trinity Health Integrity and Compliance Program, and Code of Conduct.

Functional Roles and Requirements

• PAR I (Entry Level Position):
  • Minimum one (1) year of customer service experience.
  • Patient Access experience preferred.
• PAR II:
  • Performs PAR I role and is cross-trained in Pre-Service, Emergency Department, and/or Bed Desk.
  • Minimum of two (2) years of hospital registration or insurance verification experience upon hire.
  • Knowledge of medical terminology, diagnostic coding, and procedural coding required.
  • Ability to explain insurance benefits.
• Patient Access Account Specialist:
  • Additional minimum qualification of two plus (2+) years of hospital registration or insurance verification experience.
  • Uses specialized knowledge to support key areas of the organization related to an area of expertise.
  • Uses data, research analysis, critical thinking, and problem-solving skills to support colleagues and leadership.
  • Serves as a peer influencer and may direct projects by applying industry experience and specialized knowledge.
  • Responsible for analyzing, processing, and editing for correctness based on payer guidelines.
  • Resolves items and ensures claims are billed accurately.
  • Processes payments timely.

Qualifications

• High school diploma or equivalent.
• HFMA CRCR or NAHAM CHAA certification required within one (1) year of hire.

Additional Qualifications (Nice to Have)

• Medical terminology and knowledge of diagnostic and procedural coding.
• Insurance verification experience with the ability to explain benefits and secure necessary authorization.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care.