Patient Access Rep IV - FT - Day - Patient Access Services Pennington NJ

About the role

Functions as subject matter expert to ensure department compliance with system and operational changes and assists in training to support ongoing staff education and development.

Able to perform all registration functions independently. Registers patients accurately, efficiently, and professionally to ensure database integrity and facilitate claims processing.

Applies financial screening guidelines to ensure collectable accounts. Utilizes standards, guidelines, and written procedures for performing registration functions.

Communicates effectively and works cooperatively with others. Utilizes standards, guidelines, and written procedures for performing registration functions.

Responsibilities

• Assists in training, problem solving, and chart review with subordinate patient access representatives.
• Assigns duties to registrars as directed by Supervisor or Manager.
• Demonstrates ability to independently manage all assigned responsibilities.
• Able to troubleshoot any department issues.
• Expert in all Patient Access department needs.
• Provides coverage in working areas as required when on-call duties apply.
• Advanced in registering patients quickly and accurately, exceeding productive levels of a Patient Access Rep III.
• Acts as a liaison for physician offices and ancillary departments as needed.
• Serves as a resource for Patient Access department.
• Leads department through daily workload and divides work as needed.
• Follows compliance with computer system procedures, department procedures, and training guidelines to accurately complete each registration.
• Reviews charts for accurate demographics, Medicare compliance, proper CPT codes, authorizations and referrals, necessary signatures, and completion of all forms.
• Performs follow up with physician office, central scheduling and insurance companies to obtain any required authorization, referrals or to obtain update physician orders.
• Complies with department procedures and regulatory guidelines for Medicare Secondary Payer, Medicare Medical Necessity, Advance Beneficiary Notice, Advance Directives, Patients’ Rights, and the Interpreter flag as measured by review and observation.
• Follows and monitors staff compliance with following payer requirements for authorization, pre-authorization, referrals, coordination of benefits, and in-network verification according to Insurance Database, and Insurance Verification guidelines.
• Follows Self Pay procedure regarding No Surprise Billing Act and referrals to Medicaid and charity.
• Assists with departmental training and education of patient access staff.
• Communicates effectively with Patient Access team members and is open to feedback and suggestions in order to identify opportunities for improvement.
• Identifies and seeks out members of the registration department as a resource to increase knowledge and seek validation of department guidelines and procedures.
• Reports to Management Team regarding department deficiencies to include faulty equipment, supplies and concerns.
• Supports department performance improvement initiatives.
• Communicates ideas to meet department goals.
• Attends all mandatory department meetings.
• Follows patient identification policy.
• Performs other duties as needed.

Requirements

Frequent physical demands include: Sitting , Wrist position deviation , Pinching/fine motor activities

Occasional physical demands include: Standing , Walking , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl

Continuous physical demands include: Talk or Hear

Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.

Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Depth Perception, Accurate Hearing

Anticipated Occupational Exposure Risks Include the following: Bloodborne Pathogens , Airborne Communicable Disease , Extreme Noise Levels , Dust/Particulate Matter

Qualifications

• Education: High school diploma or equivalency.
• Experience: Two-year patient access experience.
• Knowledge of all Capital Health departments required.

Skills

• Excellent verbal and written skills.
• Strong customer service and problem-solving skills.
• Proficient computer skills.
• Advanced health insurance and prior authorizations knowledge.

Benefits

The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level. The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.