Patient Access Representative 1

About the role

This position is part-time and benefits eligible. The department shift hours are Monday through Friday from 7:00 AM to 3:30 PM, and Saturday and Sunday from 7:00 AM to 3:30 PM.

Major Responsibilities

• Creates the initial electronic health record that serves as the foundation of the patient medical record that is utilized by all members of the healthcare team.
• Prevents creation of duplicate medical records that can cause treatment safety issues and billing problems.
• Follows and ensures compliance with the mandate of the organization’s accrediting bodies to use identifiers to positively identify a patient prior to the delivery of patient care to ensure patient safety.
• Checks in and registers patients; obtains and verifies complete demographic, guarantor, and insurance information; discusses and collects co-pays and other out-of-pocket patient responsibilities.
• Obtains accurate information at the point of registration helps ensure timely payment to the organization and prevents billing issues and patient complaints.
• Maintains complete confidentiality regarding patient personal/financial information and medical records in accordance with the Health Insurance Portability and Accountability Act (HIPAA).
• Knows insurance basics and recognizes commercial and government plans.
• Understands which plans Advocate Health contracts with and when a statement of financial responsibility is needed.
• Understands and discusses financial information and obligations with patients.
• Knows how and when to refer patients to Financial Advocates.
• Has knowledge of which rules, forms and questions must be enforced to make sure Advocate Health remains compliant with government agencies and regulations.
• Knows how to obtain patient or guarantor signatures as required.
• May schedule patient appointments: may also coordinate cancellations, reschedules, wait list requests, and recall requests.
• Provides accurate, detailed information regarding test preparations, patient arrival time, medication/food/beverage consumption guidelines, check-in procedures, directions to facility, etc.
• Creates a welcoming and professional environment for our patients and visitors by demonstrating extraordinary customer service.
• Greets patients and visitors and responds to routine requests for information.
• Answers telephone, screens calls, and takes messages.
• Offers various assistance to patients to include arranging transportation needs, providing directions, locating a wheelchair, coordinating interpreter services, etc.
• Maintains complete confidentiality regarding patient personal/financial information and medical records in accordance with the Health Insurance Portability and Accountability Act (HIPAA).
• Monitors and works assigned electronic health record work queues, following the department’s approved process.

Knowledge, Skills & Abilities

• Demonstrate the Advocate Health purpose, values and behaviors.
• Ability to work in a high profile and high stress area, working independently to set and meet deadlines, multitask and prioritize work.
• Must be able to handle large workloads with many interruptions in a fast-paced environment without direct supervision.
• Strong attention to detail and accuracy.
• Excellent customer service skills in a variety of situations.
• Must have excellent service recovery skills.
• Demonstrated independent thinking and problem-solving skills, ability to exercise judgment to triage issues and concerns.
• Excellent communication (written & verbal), customer service and interpersonal skills, ability to effectively communicate with a variety of patients, visitors, staff and physicians in a pleasant professional demeanor.
• Educate patients on the insurance coverage aspect of their care including managing the discussion for services that will not or may not be paid by their health plan.
• Interact with physicians and their staff to resolve issues related to patient care.
• Collect and manage payments including cash payments and follow security related to cash handling.
• Strong understanding and comfort level with computer systems.
• Demonstrated technical proficiency including experience with insurance verification/eligibility tools, EPIC electronic medical record, patient liability estimation tools, electronic email, Microsoft Office, internet browser and phone technology.
• Understanding of basic medical and insurance terms and abbreviations typically used in the patient scheduling and registration process.
• HIPAA-compliant and knowledgeable of applicable state and federal rules/regulations.
• Ability to handle sensitive and confidential information according to internal policies.
• General understanding of health insurance: Medicare, Medicaid, managed care, and commercial payers.
• Knowledge and ability to articulate explanations of Medicare/HIPAA/EMTALA rules and regulations and comply with updates on insurance pre-certification requirements.
• Excellent organizational skills.
• Demonstrated ability to effectively act as a resource to other staff.

Physical Requirements And Working Conditions

• This position may require travel, therefore, will be exposed to weather and road conditions.
• Responds quickly to patient medical status and emergency situations occurring in clerical areas.
• CPR certification may be required based on service location.
• Notary training/licensure may be required as appropriate for service line and/or facility.
• Operates all equipment necessary to perform the job.
• Exposed to a normal office environment with significant patient and public contact.
• May be exposed to ill or contagious patients.
• Must be able to transition from sitting to standing frequently.
• Must be able to stand and sit for extended periods of time and be physically mobile throughout the workday.
• Frequently lifts to 10 lbs. and occasionally lifts 20 lbs. or more.
• Must be able to push/pull up to 50 lbs. with assistance.
• Occasionally moves equipment, supplies and/or when transporting patients through doorways, ramps and elevators.
• Escorts patients to nursing units or outpatient departments as necessary.
• Sensory requirements include vision, hearing and touch. Must also be able to speak clearly.
• Must be able to use hands with fine motor skills for keyboard data entry.
• May be asked to work a flexible schedule at times to meet the needs of the department.

Preferred Job Requirements

• Experience Required: Preferred: experience with insurance verification/eligibility tools, EPIC electronic medical record, patient liability estimation tools, electronic email, Microsoft Office, Internet and phone technology.