Patient Access Representative

About the role

Our fast-paced Ambulatory Surgery Center is committed to producing the highest quality work and experience for patients and their families.

Responsibilities

• Complete and accurate registration of all patients obtaining services at the facility.
• Gather and enter patient information into the computer as received from the patient and/or the physician’s office.
• Verify benefits for non pre-registered patients and obtain signatures on required forms.
• Collect co-payments, deductibles, and co-insurance from patients at the time of service.
• Ensure an efficient, complete, and timely patient registration process that models the customer service philosophy of the facility.
• Communicate with clinical departments or Scheduling Representative to obtain scheduled appointments and/or orders prior to the service date.
• Pre-register 98% of all scheduled patients a minimum of three (3) business days in advance of their arrival.
• Obtain, validate and accurately enter in the computer system the patient’s demographic and insurance information while maintaining an acceptable accuracy rate (95% plus) as evidenced by routine quality review.
• Thoroughly review the MPI to avoid duplicate medical record numbers.
• Ensure MSP Questionnaire is completed for every Medicare registration.
• Work closely and cooperatively with the physician office staff, schedulers and other hospital departments to schedule and prepare required information before the patient’s arrival.
• Utilize online programs to verify insurance eligibility and benefits, documenting findings on the patient account.
• Assist by contacting the insurance company for pre-authorizations and pre-certifications as required prior to patient receiving service when asked by Director.
• Effectively communicate with physician office staff to resolve authorization issues and coordinate registrations as required.
• Collect co-payment, deductible or co-insurance previously identified by the Insurance Verification Specialist or as indicated on the insurance card or online eligibility system, when the patient arrives for service.
• Ensure compliance with the EMTALA regulation for all patients if working in Emergency registration.
• Log cash collected, generate receipts, and maintain balanced cash at all times.
• Meet monthly cash collection goals as determined collaboratively by Department Director/Manager and CBO.
• Obtain and copy/scan insurance cards and driver licenses.
• Know the functions of the phone system to professionally handle incoming calls, appropriately transfer calls, and assist with any internal calls when asked.
• Perform the reception/greeter function at the front desk entrance as needed.
• Verify medical licensure and check Medicare Sanctions websites for non-credentialed physicians ordering outpatient diagnostic tests (Community Hospital Only).
• Demonstrate premier customer service and communication skills with all internal and external customers/contacts.
• Meet established quality and productivity standards for self and for the team.
• Anticipate and adapt to change in a positive manner.
• Foster and reinforce team-based results.
• Adhere to time and attendance standards as outlined in the Human Resource Policy manual.
• Ensure patient confidentiality adhering to HIPAA guidelines.
• Demonstrate the knowledge, skills and abilities to perform the duties outlined annually in the form of a test or as evidenced by daily quality review and direct observation.
• Track and monitor productivity as requested.
• Keep Department Director or Team Lead apprised of any delays in the registration process.
• Remain current on scheduling, registration, insurance verification, and other patient registration processes.

Qualifications

• High School graduate or equivalent required; 2 years college preferred.
• Experience in patient registration, verification and authorization in a medical center or comparable institution preferred.
• Working knowledge of governmental regulations and other reimbursement criteria preferred.
• Ability to accurately type 40 WPM, complete forms, simple correspondence, handle payment transactions and enter data.
• Excellent verbal and written communication as well as interpersonal skills required.
• Demonstrated ability to handle multiple tasks with short time-lines, prioritize and organize work, and complete assignments in a timely and accurate manner.
• Exceptional ability to interact and communicate effectively, tactfully, and diplomatically with patients, families, medical staff, co-workers, employers and insurance company representatives.
• Must have a pleasant disposition, positive attitude and possess the ability to maintain a cordial and professional approach during periods of stress.
• Skill in using office equipment: basic computer skills, photocopier, telephone, fax machine, and calculator.
• Demonstrated ability to think and act decisively in a timely manner.
• Ability to maintain operational knowledge of all insurance requirements necessary to achieve optimal reimbursement.

Benefits

• Medical, dental, vision, and prescription coverage
• Life and AD&D coverage
• Short- and long-term disability
• Flexible financial benefits including FSAs, HSAs, and Daycare FSA
• 401(k) and access to retirement planning
• Employee Assistance Program (EAP)
• Paid holidays and vacation

Pay

$25–$30/hour