Patient Access Representative II Main Outpatient

Working Location: THOP Transmountain Campus

Shift Information: Monday–Friday days with rotating weekends. Spanish required.

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, and after date of service.

Responsibilities

• Greet patients following Conifer Standards of Care, 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 services, Consent for treatment, Important Message from Medicare, EMTALA, etc.).
• 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, other tasks as needed).
• Educate patients about patient financial liabilities, 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 and 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, and 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 that lead to more effective communication and a higher level of productivity and accuracy.
• Appropriately 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 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.

Physical Demands

• Must be able to sit at a computer terminal for extended periods of time.
• Resolve physician’s office and patient issues; 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.