Patient Access Representative

Department Job Description Summary

Aventura Diagnostics Bilingual in Spanish required
Monday-Friday 8:30a-5p
Provides accurate and timely patient registration, including demographic intake, insurance verification, authorizations, and compliance documentation.
Ensures patient understanding of consent, privacy, and financial policies while supporting up-front collections and maintaining regulatory compliance (HIPAA, EMTALA, Medicare/Medicaid).

Position Responsibilities

• Collects accurate and complete patient information (i.e. legal name, permanent/local address, phone number, next of kin, employer, guarantor, insurance information, physician etc., and enters in the system within the established time frames.)
• Verifies insurance information, which include eligibility, benefits (i.e. Deductibles, co-payments, out of pocket expenses, maximum lifetime coverage, exclusion/limitations/pre-existing conditions, etc.) and obtains appropriate referrals, pre-certification, and/or authorizations for all patient as follows: scheduled patients no later that 24 hours.
• Enters complete insurance verification information
• Ensures that a copy of insurance cards, front and back, as well as a copy of a picture ID is obtained and scanned at time patient presents for service.
• Provides and explains all registration documents (i.e. General consent forms, Advance Directive information, Patient Rights information and Privacy Notice information).
• After completion of registration process ensures all registration documents, as well as orders, accompany the patient to the appropriate area (i.e. Nursing units, ancillary departments, etc.).
• Prior to the end of shift conducts self-audit of all registration to insure that information is accurate and complete.
• Demonstrates full knowledge of Compliance Advisor's functionality as it relates to Medicare Compliance and accurately enters diagnosis according to prescription to check for ABN compliance.
• Ensures that every registration has attached correct procedure, diagnosis (no R/O), printed physician's name and address on RX/referral and signature of doctor when indicated.
• Assists patient in understanding his/her insurance benefits and explains hospital financial and deposit policies including up front collections and follows established guidelines for up-front collections and collects and disburses revenue.
• Maintains compliance of Patient Access processes and Federal State and Local Laws and regulatory standards (ACHA, HIPPA, Medicare, Medicaid, EMTALA, COBRA, etc.).
• Demonstrates flexibility as well as ability to perform multiple functions within the Patient Access department.
• The individual is cross-trained to perform duties across various areas of areas assigned.

  Qualifications

  • Bilingual in Spanish required
  • Education: High school graduate or equivalent level of training. Some college preferred
  • Experience: 1-3 years' practical experience in registration, collections and insurance verifications preferred. Hospital Registration or Physician Office Front Desk experience

  Benefits

  • Health benefits
  • Life insurance
  • Long-term disability coverage
  • Healthcare spending accounts
  • Retailment plan
  • Paid time off
  • Pet Insurance
  • Tuition reimbursement
  • Employee assistance program
  • Wellness program
  • On-site housing for select positions and more!

  Certification

  • Degree Requirements: None specified