Patient Access Represenative II

Job Requirements

High school diploma or GED.

• Two (2) years of work experience in a clerical, customer service, or receptionist position.
• Preferred: Four (4) years of work experience in a clerical, customer service, or receptionist position.
• Previous experience in a healthcare setting.

Responsibilities

• Schedules, registers, processes pre-admission, and provides wayfinding services.
• Verifies insurance benefit eligibility, pre-certification, and authorization.
• Creates and finalizes cost estimates.
• Identifies and eliminates barriers to access, reimbursement, and affordable care.
• Provides education to patients and families regarding the financial clearance process and available financial assistance opportunities.
• Performs specific administrative and ADT functions across multiple clinics and registration areas.
• Serves as the first point of contact for patients and visitors, focusing on customer service and maintaining a quality-conscious work environment.
• Collects and verifies patient and insurance demographics; reviews benefits information in Epic; provides cost estimates; secures pre-certifications and/or pre-notifications for patient services; collects co-pays and deposits prior to services; and provides financial assistance information to patients.
• Maintains regulatory and functional knowledge of required registration information to ensure timely and accurate reporting and billing; obtains all required signatures; and performs clerical duties as necessary.
• Edits and educates patients regarding adequate insurance coverage; understands applicable hospital and physician billing requirements and communicates proper procedures and requirements to patients; communicates coverage issues to service areas and works with patients and staff to resolve them.
• Ensures accuracy and completion of paperwork prior to filing admissions; contacts physician and clinical staff to resolve incomplete patient registration documentation and distributes admission documents as required.
• Maintains department scheduling templates for applicable providers in outpatient department locations, ensuring appropriate scheduling utilization.
• Maintains consistent contact with the Care Management and Social Work departments to ensure required information has been obtained for reimbursement and that pre-admission and pre-certification requirements are followed.
• Acts as an official training resource for departmental training of new and existing employees.