Patient Access Representative II

Patient Access Representative II, FT, Days

About the role

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

Responsibilities

• Verifies insurance benefit eligibility, insurance pre-certification and authorization, and creates/finalizes cost estimates.
• Works with care teams and the revenue cycle to identify and eliminate barriers to access, reimbursement, and affordable care.
• Provides education to patients and families regarding the financial clearance process and offers information related to estimated costs of services and available financial assistance opportunities.
• Serves as the first point of contact for patients and visitors who enter the facilities and is responsible for customer service in Patient Access/Patient Administrative Services areas in a manner that ensures a customer-focused, quality-conscious work climate, recognizing that patient visits are often filled with anxiety and uncertainty.
• Collects and verifies patient and insurance demographics; verifies insurance benefits and coverage by reviewing benefits information in Epic; provides cost estimates; secures pre-certifications and/or pre-notifications for patient services; collects co-pays and deposits prior to services; and provides financial assistance information to patients.
• Maintains regulatory and functional knowledge of all required registration information to ensure timely and accurate reporting and billing; obtains all required signatures; and performs clerical duties as necessary.
• Educates patients regarding adequate insurance coverage. Understands applicable hospital and physician billing requirements and communicates proper procedures and requirements to patients.
• Communicates coverage issues to service areas and works with patients and staff to resolve them.
• Ensures accuracy and completion of paperwork prior to filing admissions. Contacts physician and clinical staff to resolve incomplete patient registration documentation and distributes admission documents as required.
• Maintains department scheduling templates for applicable providers in outpatient department locations, ensuring appropriate scheduling utilization.
• Maintains consistent contact with the Care Management and Social Work departments to ensure required information has been obtained for reimbursement and that pre-admission and pre-certification requirements are followed.
• Acts as an official training resource for departmental training of new and existing employees.

Requirements

• High school diploma or GED.
• Two (2) years of work experience in a clerical, customer service, or receptionist position.
• Four (4) years of work experience in a clerical, customer service, or receptionist position.
• Previous experience in a healthcare setting.

Qualifications

• Knowledgeable of clinic locations to safely and efficiently guide patients to their appointments.
• Maintains consistent contact with the Care Management and Social Work departments to ensure required information has been obtained for reimbursement and that pre-admission and pre-certification requirements are followed.
• Acts as an official training resource for departmental training of new and existing employees.

Skills

• Strong interpersonal skills.
• Data collection.
• Absorbs and assesses situations.
• Assists the team in developing solutions to achieve excellence in customer service while ensuring the financial viability of the hospital.

Benefits

• Shift Differentials

Pay

• Pay Range: $17.68 - $24.76

Schedule

• Monday - Friday 10:30AM-7PM Every Other Weekend 6:30AM-3:00PM