Patient Access Representative 2 - Hospital (Cancer Center)

About the Role

The Patient Access Representative 2 (PAR 2) facilitates a welcome and easy access to the facility and is responsible for establishing an encounter for any patient who meets the guidelines for hospital service. The PAR 2 ensures accurate data entry, including demographic and financial information for each account, and handles numerous procedural requirements such as insurance verification, authorization for services, and collections for patient portions including prior balances. The role involves balancing cash at shift end and communicating directly with patients, families, physicians, nurses, insurance companies, and third-party payers. The PAR 2 may also serve as a team lead, participate in process improvement initiatives, mentor new hires, and audit for regulatory and billing compliance.

Responsibilities

• Customer Service
  • Effectively meets customer needs, builds productive customer relationships, and takes responsibility for customer satisfaction and loyalty.
  • Represents the Patient Access department in a professional, courteous manner at all times.
  • Asks patients if they may have special needs and calls patients by name.
  • Greets patients in a courteous and professional manner.
• Quality
  • Adheres to the Passport accuracy percentage rate of 97.5% or above on a consistent basis when registering accounts.
  • Supports the flexible needs of the department to accommodate patient volume in all areas of the hospital, including potential reassignment or shift changes.
  • Supports the department in achieving established performance targets.
  • Completes required training as needed.
  • Demonstrates reliability and dependability by reporting to work when scheduled.
• Financial Collections
  • Calculates and collects the estimated patient portion based on benefits, contract reimbursement, and prior balances.
  • Utilizes appropriate language and behavior to collect patient financial responsibility.
  • Collects co-payments, deductibles, deposits, and/or amounts due on previous accounts.
  • Reviews notes on all pre-admitted accounts and discusses them with customers in a courteous and professional manner.
  • Reviews and explains previous accounts.
  • Completes account acknowledgement forms when appropriate.
  • Collects cash, prints receipts, and balances cash drawers.
• Insurance and Benefits Knowledge
  • Demonstrates knowledge of insurance plans.
  • Verifies eligibility and obtains necessary authorizations for services rendered.
  • Completes Medicare Secondary Payor Questionnaire.
  • Utilizes online eligibility tools.
  • Obtains authorization/verification from required insurance companies.
  • Utilizes appropriate software and worksheets to calculate patient financial responsibility.
  • Performs financial assessments for appropriate program assistance.
  • Utilizes appropriate guidelines to assist patients with financial responsibility.
  • Demonstrates accuracy in selected insurance plans (I-plans).
• Registration
  • Obtains and accurately inputs all required data elements for registration, including patient demographic, financial information, guarantor information, and relevant notes associated with the encounter.
  • Prioritizes and completes registration in a consistent, courteous, professional, accurate, and timely manner.
  • Ensures each patient is assigned only one medical record number.
  • Selects appropriate patient type based on the department and services required.
  • Communicates the purpose of and obtains patient/legal guardian signatures on all necessary hospital documents (e.g., hospital consent forms, assignment of benefits, patient rights).
  • Documents in account notes.
  • Ensures orders are received and are consistent with tests/procedures.
  • Provides patients with documents they need to take to other departments.
• Leadership
  • Serves in a team lead role (if assigned).
  • Participates in and assists with performance improvement initiatives.
  • Demonstrates an understanding and compliance of all department policies and procedures.
  • Mentors and trains other associates.
  • Acts as an auditor for regulatory and billing compliance.
• Other Duties
  • Performs all other duties as assigned.

Qualifications

• Education: High School diploma or equivalent.
• Experience: 2 years of relevant experience in the healthcare industry. Related certification (e.g., Certified Coder, Certified Medical Assistant) substitutes for 1 year of experience.