Patient Access Representative Full Time

About the role

Welcome to West Coast Joint and Spine West Coast Joint and Spine Center is hiring a Patient Access Rep. Our fast-paced Ambulatory Surgery Center is committed to producing the highest quality work and experience for patients and their families.

Responsibilities

• 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 so that duplicate medical records numbers are avoided.
• Obtain signatures on all necessary forms and documents required by hospital and by law.
• 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.
• Work closely with 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.
• 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.
• Consistently obtain and copy/scan insurance cards and driver licenses.
• 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).
• Provide proper notification of absence or tardiness within established departmental time frames.
• Ensure patient confidentiality adhering to HIPAA guidelines.
• Track and monitor productivity as requested.
• Remain current on scheduling, registration, insurance verification, and other patient registration processes in order to cover in the absence of other team members.
• Perform other duties as assigned.

Qualifications

• A high school graduate or equivalent required; 2 years college preferred.
• Experience in patient registration, verification and authorization in a medical center or comparable institution demonstrating the skill, knowledge and ability to perform registration duties preferred.
• A working knowledge of governmental regulations and other reimbursement criteria preferred.
• An 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.
• An exceptional ability to interact and communicate effectively, tactfully, and diplomatically with patients, families, medical staff, co-workers, employers and insurance company representatives.
• 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.
• The ability to think and act decisively in a timely manner.
• A demonstrated ability to maintain operational knowledge of all insurance requirements necessary to achieve optimal reimbursement.