Patient Access Representative - ED Outpatient - Fri & Sat 3 PM - 1:30 AM

10-hour afternoon to evening shift.

About the Role

Under the supervision of the Patient Access Supervisor, this position ensures the delivery of outstanding customer service while greeting patients, registering patients, and verifying or obtaining complete and accurate patient demographic information. Responsibilities include identifying patient benefits eligibility, verifying pre-certification from insurance companies and/or physicians' offices, determining insurance and/or patient responsibility, collecting identified co-pay/deductible, co-insurance, and providing financial counseling when appropriate. The role completes the entire registration process.

Responsibilities

• Capture and document all pertinent patient demographic, subscriber, and insurance information (e.g., patient policy and ID numbers, subscriber, guarantor, payor address, phone number, and contact information). Documentation must include effective date, copay, deductible, out-of-pocket, co-insurance, stop-loss amounts, percentage of coverage, and any other pertinent information concerning the specific visit into the EHR system.
• Obtain complete and accurate insurance information; complete insurance verification by contacting patients, physician offices, and insurance/payer regarding the visit; verify patient’s insurance eligibility and benefits with the information obtained.
• Review work and ensure accuracy in all aspects of the position, particularly patient type, visit type, code identification, insurance information, and demographic information to minimize error rate and time delays in other areas.
• Assess and collect financial liabilities prior to service when applicable; educate patients on the billing process for the facility; refer patients for financial counseling if applicable; document payment information in the system as appropriate.
• Scan appropriate data into the Document Management System (including, but not limited to, insurance cards, driver’s license, physician orders, consent forms, and any other registration-related documents pertinent to the patient's medical record).
• Identify patient's history in all Patient Access Systems to avoid duplication of medical records.
• Confirm and update the EHR system with pre-certification information for all scheduled and non-scheduled outpatient accounts as applicable.
• Perform medical necessity checks on all applicable appointments; complete ABN form upon any failure to meet medical necessity.
• Obtain and accurately complete MSP forms when applicable.
• Demonstrate ability to complete and explain all registration-related consents and other documents as needed to the patient.
• Prepare patient packets for the next day's scheduled procedures (varies per area).
• Work according to standard operating procedure during EHR or other system downtimes.
• Work with physician offices and other departments to ensure patient satisfaction is met.
• Understand and utilize all systems appropriately as related to the registration process.
• Meet all goals set by department management, including but not limited to productivity, accuracy, collections, and customer satisfaction.
• Perform any and all related job duties as assigned; may have additional department-specific duties assigned as deemed necessary by management.
• Maintain open and positive professional communication (oral and written) as well as a great attitude at all times.
• PRN for Registration and ED Registration are responsible for accurately performing any and all functions listed above.

Requirements

• High School Diploma or GED.
• Must be mobile and able to push patients in a wheelchair, if necessary, between any location within the hospital campus.

Qualifications

• Preferred Licensure or Certifications: Bilingual preferred.
• Preferred Education: Associate or Bachelor’s Degree in Business, Financial/Healthcare-related field.
• Preferred Experience: Medical terminology, data entry and computer experience, admitting, business office, collection, physician office experience, and working with the public.

Skills

• Ability to work independently, emotionally mature, and able to function effectively under stress while continuing to demonstrate a positive attitude with patients at all times.
• Excellent problem-solving and analytical skills.
• Working knowledge of Protected Health Information.
• Ability to be flexible and manage change.
• Excellent written and oral communication skills.
• Proficient with the use of all Patient Access Systems, Software Applications, and Processes.
• Demonstrate knowledge of billing requirements and proper documentation.
• Possess a detailed understanding and knowledge of insurance guidelines and protocols, the components of full verification, and payor information/requirements.

Physical Demands

• Weight Lifted: Up to 20 lbs, occasionally (0-30% of the time).
• Weight Carried: Up to 20 lbs, occasionally (0-30% of the time).
• Vision: Heavy, occasionally (0-30% of the time).
• Kneeling/Stooping/Bending: Occasionally (0-30% of the time).
• Standing/Walking: Frequently (31-65% of the time).
• Pushing/Pulling: Occasionally (0-30% of the time).
• Intensity of Work: Frequently (31-65% of the time).
• Job Requires: Reading, writing, reasoning, talking, keyboarding.