Patient Access Representative I, PRN

Patient Access Representative I

Performs scheduling, registration, pre-admission processing, wayfinding, and other administrative duties in accordance with department-specific standards for data entry and patient selection.

• Verifies insurance benefit eligibility and completes insurance pre-certification and authorization.
• Creates and/or finalizes 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.
• Fulfills roles including focusing on interpersonal skills, data collection, the ability to assess situations, and assisting the team in developing solutions to achieve excellence in customer service while ensuring the financial viability of the hospital.
• 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.
• 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. Ensures 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.

Compensation

Pay Range: $17.00 - $21.39

Other Compensation (if applicable): Shift Differentials