Patient Access Representative - Full-Time - AVALA Hospital - RH385 - RH462

Essential Duties and Responsibilities

• Verifies that patient demographic information is accurate and ensures that insurance cards, consents and other admission documents are complete and in order.
• Able to explain required forms to the patient in detail (i.e.: Authorization for Treatment, Advanced Beneficiary Notice (ABN), and Medicare Secondary Payer (MSP) questionnaire). Obtains required signatures as needed.
• Contacts patient to verify demographic information, insurance information, and MSP questionnaire.
• Verifies insurance coverage and understands benefit requirements and ensures that all notification/authorizations are completed based on plan requirements.
• Works with physician offices to obtain necessary authorization on scheduled procedures.
• Explains insurance benefits to patient.
• Informs patients of estimated balance due based on plan benefits and collects monies due at time of service.
• Demonstrates knowledge of all features and functions of the Patient Accounting areas.
• Notifies appropriate staff regarding any issues or concerns in a timely manner.
• Balances daily receipts list to cash, checks, and credit card payments received at the end of each day.
• Communicates with management/physician offices regarding any problematic insurance concerns that may affect the payment of services.

Core Competencies

• Action Orientation
• Communications
• Critical Judgment
• Customer Orientation
• Interpersonal Skills
• Leadership
• Teamwork

Professional Requirements

• Maintains dress code standards and policies.
• Completes annual education requirements.
• Maintains regulatory requirements.
• Maintains patient confidentiality at all times.
• Reports to work on time and as scheduled, completes work within designated time.
• Wears identification while on duty, uses computerized punch time system correctly.
• Completes in-services and returns in a timely fashion.
• Attends annual review and department in-services, as scheduled.
• Attends staff meetings or reads and returns all monthly staff meeting minutes.
• Represents the organization in a positive and professional manner.
• Participates in performance improvement and continuous quality improvement (CQI) activities.
• Complies with all organizational policies regarding ethical business practices.
• Communicates the mission, ethics and goals of the hospital, as well as the focus statement of the department.
• Assists other staff members in performing any duty that enhances the delivery of patient care.
• Maintains regulatory requirements.

Physical Demands

• Regularly required to talk and hear.
• Very active and requires repetitive motions, standing, walking, bending, kneeling and stooping all day.
• Frequently lifts or moves items weighing up to 20 pounds.