Patient Access Representative III

Working Location: THOP East Campus Physical Therapy Clinic – Day Shift. Spanish language skills required.

About the Role

Responsible for a wide range of duties in support of departmental efficiencies, including registration, patient pre-admission and admission, reception and discharge functions, arranging support hospital services requested by patients through referrals, performing thorough analysis of admission discharge transfers (ADT), revenue cycle reports, leading shift Patient Access Operations, and collaborating with department leaders in process and operational excellence.

Responsibilities

• Greet patients following Conifer Standards of Care, provide world-class customer service, and complete full patient registration at date of service while adhering 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 or surgical procedures, conducting physician office/patient interviews, and explaining hospital procedure guidelines and policies.
• Provide full patient financial counseling, education, and referrals; employ and complete all patient liability collection escalations through proper, compliant 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 and obtain insurance authorizations for scheduled and unscheduled hospital services.
• Secure inpatient visit notification to payors.
• Perform thorough analysis of admission discharge transfers (ADT) and revenue cycle reports.
• Lead shift Patient Access Operations and collaborate with department leaders in process and operational excellence.
• 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.

Requirements

• High School Diploma or GED required; some college coursework preferred.
• 2–4 years of experience in a medical facility, health insurance, or related area; 2+ years in Patient Access preferred.
• Minimum typing skills of 35 words per minute.
• Demonstrated working knowledge of software, systems, equipment, and PCs.
• Knowledge of hospital environment and relationships preferred.
• Advanced customer service skills and experience.
• Ability to work in a fast-paced environment and handle detailed information through oral and written communications.
• Advanced understanding of third-party payor requirements preferred.
• Advanced understanding of compliance standards preferred.
• Advanced patient liability collection performance and high achievement in productivity.
• Must be able to perform essential job duties in at least three Patient Access service areas, including Emergency Departments.

Skills

• Customer service and patient interaction.
• Financial counseling and patient liability collection.
• Insurance verification, benefits, and eligibility checks.
• Medical necessity verification and compliance standards.
• Data entry, cash reconciliation, and report analysis.
• Collaboration with department leaders and operational excellence.

Physical Demands

• Must be able to sit at a computer terminal for extended periods of time.
• Occasionally lift and 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, including potential exposure to life-threatening patient conditions.
• May experience extreme patient volumes and uncooperative patients.
• Must be available to work hours and days as needed based on departmental/system demands.
• Resolves physician office and patient issues.

As applicable and permitted by law, candidates may be required to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment, including but not limited to COVID-19 and influenza vaccinations.