Patient Access Representative
Primary Responsibilities
- Performs insurance verification duties to financially clear the patient in advance of date of service
- Verifies healthcare coverage and benefits for applicable services, working with the patient, provider, and payer to ensure accurate information and needs are met in advance of service
- Ensures excellent customer service when assisting patients, providers, and other departments
- Collections and updates patient demographic and insurance information, making changes as necessary to ensure accuracy with insurance benefits, referrals, and authorizations
- Verifies precertification / authorizations for scheduled services utilizing internet sites, payer contacts, and software as appropriate
- Accurately determines patient responsibility as applicable
- Identifies self-pay patients and shares information with financial counseling for assistance with patient financial obligation and options
- Pairs closely with the clinical, office, billing, and registration teams and works to review authorizations timely, as applicable
- Appropriately documents all conversations with insurance companies and health care facilities that pertain to the authorizations or payment of services
- Escalates questions or concerns to leadership as needed
- Maintains and exhibits a current knowledge of insurance plans, associated workflows and information, and the impact of this role within the revenue cycle
- Remains aware of department productivity expectations, and other measurable performance data and meets / exceeds individual contributions to the team performance
- Strives to maximize revenue and minimize bad debt
- Maintains a safe environment complying with NLH policies and procedures; reports and directly addresses environmental hazards and violations of patient safety policy and / or protocol when involved or observed
- May perform other duties upon request
Required Qualifications
- High School Diploma/GED
- 6+ months of experience in an office setting, customer service setting (over the phone OR face to face), phone support role or call center environment
- Intermediate level of proficiency with Microsoft Office products
- Influenza vaccination for the current flu season (typically August-May) or commitment to receive the influenza vaccination when available for the upcoming flu season
- Ability to work Monday - Friday from 8:00am - 4:30pm
Preferred Qualifications
- 1+ years of Patient Access experience in a hospital OR medical setting
- Prior experience working an overnight schedule
- Understanding of medical terminology
- Working knowledge of insurance policies, procedures and patient care settings
Benefits
Our mission of helping people live healthier lives extends to our team members. Learn more about our range of benefits designed to help you live well.
Life
- Resources and support to focus on what matters most to you, in every facet of your life.
Emotional
- Education, tools and resources to help you reduce and manage stress, build resilience and more.
Physical
- Health plans and other coverage to support wellness for you and your loved ones.
Financial
- Benefits for today and to help you plan for the future, including your retirement.
About the Role
Opportunities at Northern Light Health, in strategic partnership with Optum. Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities. If the place for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits and discover the meaning behind: Caring. Connecting. Growing together.
Schedule
Monday - Friday from 8:00am - 4:30pm
Pay
The hourly pay for this role will range from $16.15 to $28.80 per hour based on full-time employment. We comply with all minimum wage laws as applicable.