Patient Access Representative - 40 Hours, Days

Qualifications

• High School Diploma.
• PREFERRED: Associate degree.
• PREFERRED: Knowledge of third-party insurers.
• PREFERRED: Two years hospital or medical business office experience, or comparable experience with third party or collection agency.
• REQUIRED: Excellent communication, organizational and interpersonal skills.
• REQUIRED: Ability to manage multiple priorities.
• REQUIRED: Familiarity with medical terminology.
• REQUIRED: Professional demeanor and appearance as well as compassionate and patient.
• PREFERRED: Proficiency in Microsoft Office and electronic scheduling & registration systems.

Responsibilities

• Responsible for the smooth operations of all front desk/reception area functions as well as other administrative/clerical duties.
• Pre-admission and admission of all hospital outpatients, ensuring the adequate financial backing.
• Accurate and timely preparation and submission of all assigned patient accounts, including charge entry.
• Ongoing analysis of accounts to determine continuation of eligibility of benefits and implements appropriate appeals, coordination of benefits, adjustments, and re-authorizations.
• Greets and receives patients and/or visitors, collects copies of insurance information, maintains all patient demographic records, and provides patient orientation regarding hospital/department policies and procedures.
• Clinics/recurs/admits correct account for services to be rendered.
• Schedule follow-up appointments timely.
• Perform ongoing analysis of scheduled visits/accounts to determine continuation of eligibility of benefits.
• Collects co-pays as needed and balances end of day cash.
• Manage, direct and respond to incoming office correspondence as deemed appropriate, including mail, email, faxes and telephone calls and forwards queries to the appropriate staff.
• Utilizes office correspondence software as appropriate; Outlook, Mxie, TigerConnect.
• Maintain solid working knowledge of insurance coverage, benefits and authorizations, Medicare Secondary Payer (MSP) questionnaire and how to log responses, Advanced Beneficiary Notices (ABN) and Memos of Understanding (MOU’s).
• Provides estimates of Outpatient services when needed.
• Communicate benefit information to patients.
• Collaborates with outpatient authorization team when needed.
• Communicates schedule changes timely to appropriate team members.
• Cancels/reschedules/no shows patients with appropriate reason codes.
• Coordinates schedules with various vendors and equipment when prompted by provider.
• Processes incoming referrals by calling patients to make appointments within 24-48 hours, complete pre-registration, forward intake paperwork and prepare estimates.
• Collaborates with Team Leads, Office Coordinators and Administrative Assistants if necessary.
• Communicate hospital initiatives and policies such as Follow My Health (patient portal), Connie (statewide health information exchange), Financial Assistance and Release of Information processes to patients as requested.
• Keeps a neat and orderly workspace.
• Can securely open up and close up office at the start or end of business day.
• Familiar with all stations within the role and can effectively cover and cross train.
• Provides other regular support as designated by Outpatient Access Manager.