Patient Access Representative I

Patient Access Representative I

Schedule is 3P-1130P to include every other weekend and holidays schedule.

• Performs scheduling, registration, pre-admission processing, wayfinding, and other administrative duties in accordance with department-specific standards for data entry and patient selection.
• May verify insurance benefit eligibility and complete insurance pre-certification and authorization, as well as create and/or finalize cost estimates.
• Collaborates with care teams and revenue cycle partners to identify and eliminate barriers to access, reimbursement, and affordable care.
• Educates patients and families on the financial clearance process and provides information regarding estimated costs of services and available financial assistance options.
• Performs assigned administrative and Admission, Discharge, and Transfer (ADT) functions across multiple clinics and registration areas within the institution.

Principal Responsibilities And Tasks

• Serves as the first point of contact for patients and visitors who enter the facilities and is responsible for all aspects of customer service for Patient Access/Patient Administrative Services areas in a manner that ensures a customer focused, quality conscious work climate recognizing that patients visits are filled with anxiety and unknowns.
• Collects and verifies patient and insurance demographics, verifies insurance benefits and coverage by reviewing benefits collection in Epic, provides cost estimates, securing pre-certifications and/or pre-notifications for patient services, collection of co-pay and deposits prior to services and providing financial assistance to patient.
• Provides wayfinding to all clinics which Patient Administrative Services provides registration assistance. Staff must be aware of clinic locations in order to safely and efficiently navigate patients to their appointments.
• Maintains regulatory and functional knowledge of all registration information required, which ensures timely and accurate reporting/billing; also obtains all required signatures, and performs clerical duties as necessary.
• Edits patients regarding adequate insurance coverage. Understands applicable hospital and physician billing requirements and communicates the proper procedures and requirements to patients.
• Communicates coverage issues to the service areas; works with patients and staff to resolve.
• Ensures accuracy and completion of paperwork, prior to filing admissions. Contacts physician/clinical staff to assist with incomplete patient registration paperwork. Distributes admission documents if required.
• Maintains department scheduling templates for applicable providers in outpatient department locations. Ensuring appropriate scheduling utilization.
• Maintains consistent contact with the Care Management team and Social Work departments to ensure required information has been obtained for reimbursement, and that pre-admission and pre-certification requirements are followed.
• Aids supervisor with training of new Admitting staff by demonstrating department operating processes and procedures.

Work Experience

• Completion of a high school level education with attainment of a high school diploma or a State High School Equivalency Certificate (GED) is required.
• Certification and memberships to local organizations such as AAHAM, NAHAM, etc. preferred.
• 1 year of work experience in a clerical, customer service or receptionist position, preferably in a healthcare setting is required. 2 years’ work experience preferred.

Additional Information

All your information will be kept confidential according to EEO guidelines.

Compensation Pay Range: $17.00 - $21.39

Other Compensation (if applicable): Shift Differentials

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