Patient Access Representative - Full-Time - Radiology - AVALA Hospital - RH469

Essential Duties and Responsibilities

• Able to handle heavy phone volumes, ensures that callers are transferred to the appropriate department and/or person. Answers calls in a timely manner; identifies department and self when answering the telephone. Able to handle all codes and stat calls proficiently.
• 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.
• As part of the pre-registration process, contacts patient to verify demographic information, insurance information, and MSP questionnaire.
• Able to verify insurance coverage and understand benefit requirements and ensures that all notification/authorizations are completed based on plan requirements.
• Work with physician offices to obtain necessary authorization on scheduled procedures.
• Able to explain 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 Access 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
• Creativity/Innovation
• Critical Judgment
• Customer Orientation
• Interpersonal Skills
• Leadership
• Teamwork

Professional Requirements

• Maintains dress code standards and adheres to 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.
• Actively 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.

Regulatory Requirements

• High school diploma.
• Two (2) or more years’ experience.

Skills

• Ability to communicate effectively in English, both verbally and in writing.
• Basic computer knowledge.

Physical Demands

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. This position is very active and requires repetitive motions, standing, walking, bending, kneeling and stooping all day. The employee must frequently lift or move items weighing up to 20 pounds.