Patient Access Representative II - ED

Working location: THOP Sierra Campus. Schedule is known 5 weeks in advance. 32 hours per week on rotating shifts (days, evenings, nights, weekends). Spanish language required.

Responsibilities

• Perform duties in support of departmental efficiencies, including scheduling, registration, patient pre-admission and admission, reception, and discharge functions.
• Obtain complete and accurate patient demographic information.
• Employ proper, compliant patient liability collection techniques before, during, and after the date of service.
• Greet patients following Conifer Standards of Care, provide world-class customer service, and complete full patient registration at the 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 Services, Consent for Treatment, Important Message from Medicare, EMTALA).
• Scan Protected Health Information, 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, and other tasks as needed).
• Educate patients about patient financial liabilities.
• 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.
• Use proper negotiation techniques to professionally collect money owed by patients/guarantors.
• Build and maintain collaborative relationships with both internal and external clients to enhance communication, productivity, and accuracy.
• Interpret physician orders, medical terminology, and insurance cards while maintaining Conifer Standards of Care.
• Perform essential job duties in at least two Patient Access service areas, including the Emergency Department.

Requirements

• High School Diploma or GED required.
• 0–1 year in a customer service role.
• 0–1 year administrative experience in a medical facility, health insurance, or related area preferred.
• Some college coursework is preferred.
• Minimum typing skills of 35 words per minute.
• 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 the Emergency Department.
• Must be able to appropriately interpret physician orders, medical terminology, and insurance cards.
• Must obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment, including COVID-19 vaccination, influenza vaccination, and any future required vaccines and screenings as permitted by law.

Skills

• Customer service and interpersonal skills.
• Ability to work in a fast-paced environment and handle extreme patient volumes and uncooperative patients.
• Strong oral and written communication skills.
• Proficiency in using computers and related technology (PC, CRT, printer).
• Understanding of medical terminology and physician orders.
• Knowledge of hospital operations and third-party payor requirements.
• Compliance with healthcare standards and regulations.

Physical Demands

• Must be able to sit at a computer terminal for extended periods of time.
• Resolve physician's office and patient issues.
• 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 and patient care locations.
• Potential exposure to life-threatening patient conditions.
• Must be available to work hours and days as needed based on departmental/system demands.