Patient Access Representative II

About the role

Responsible for duties in support of departmental efficiencies which may include performing scheduling, registration, patient pre-admission and admission, reception and discharge functions. Must obtain complete and accurate patient demographic information. Patient Access representatives also must employ proper, compliant patient liability collection techniques before, during & after date of service.

Responsibilities

• Greet patients following Conifer Standards of Care and provide world-class customer service.
• Complete full patient registration at date of service.
• Adhere to financial and cash control policies and procedures.
• Thoroughly explain and secure hospital and patient legal forms (e.g., Advance Directives, Conditions of Service, Consent for Treatment, Important Message from Medicare, EMTALA, etc.).
• Scan Protected Health Information and create and file patient information packets/folders for upcoming hospital services.
• Assist with scheduling diagnostic procedures (enter data in scheduling system, provide customer with appointment instructions, other tasks as needed).
• Educate patients about financial liabilities and employ proper, compliant patient liability collection techniques before, during and after date of service.
• Perform hospital cash reconciliation and secured payment entry in adherence to financial and cash control policies and procedures.
• Secure medical necessity checks/verification in accordance with Centers for Medicare & Medicaid Services.
• Verify insurance, benefits, coverage and eligibility.
• Complete assigned registration financial clearance work list activities.
• Obtain insurance authorizations for scheduled and unscheduled hospital services.
• Secure inpatient visit notification to payors.
• Assist with scheduling and coordinating post-discharge care for patients.
• Resolve physician’s office and patient issues.
• Interpret physician orders, medical terminology and insurance cards while maintaining Conifer Standards of Care.

Knowledge, Skills, Abilities

• Minimum typing skills of 35 wpm.
• Demonstrated working knowledge of PC/CRT/printer.
• Knowledge of function and relationships within a hospital environment preferred.
• Customer service skills and experience.
• Ability to work in a fast-paced environment.
• Ability to receive and express detailed information through oral and written communications.
• Understanding of third-party payor requirements preferred.
• Understanding of compliance standards preferred.
• Must be able to perform essential job duties in at least two Patient Access service areas including Emergency Department.
• Uses proper negotiation techniques to professionally collect money owed by patients/guarantors.
• Builds and maintains collaborative relationships with both internal and external clients that lead to more effective communication and a higher level of productivity and accuracy.

Education / Experience

• High School Diploma or GED required.
• 0–1 year in a customer service role.
• 0–1 year administrative experience in medical facility, health insurance, or related area preferred.
• Some college coursework preferred.

Physical Demands

• Must be able to sit at a computer terminal for extended periods of time.
• May experience extreme patient volumes and uncooperative patients.
• Occasionally lift/carry items weighing up to 25 lbs.
• Frequent prolonged standing, sitting, and walking.
• Occasionally push a wheelchair to assist patients with mobility problems.

Work Environment

• Hospital administration.
• Can work in patient care locations which include potential exposure to life-threatening patient conditions.
• Must be available to work hours and days as needed based on departmental/system demands.