Patient Access Representative - Part Time

About the role

This position performs imperative duties including but not limited to appointment scheduling, registration, insurance verification, telephone coverage, patient collections, registration follow up, and customer service. Acts as a trainer and/or subject matter expert for the team.

Responsibilities

• Registers patients by verifying identity and interviewing patient or representative in a pleasant, professional, and timely manner according to department practices.
• Ensures all necessary demographic and financial data is obtained and accurately entered into the electronic health record (EHR).
• Validates existing data related to prior registrations by asking patient to repeat all data and updating appropriately in the EHR.
• Identifies appropriate payor sources and verifies eligibility according to department procedure for all patients.
• Checks to ensure authorization has been obtained prior to services being rendered. If authorization is not in place, follows Financial Clearance policy.
• Creates and discusses Intent to Proceed with a Non-Authorized Service forms as needed.
• Scans all appropriate documentation into the EHR.
• Refers all private pay and underinsured patients to the Financial Counselors or Eligibility Advocate.
• Initiates patient financial conversations with respect and privacy. Creates estimates for services and delivers to patient. Collects estimated amount due per TFH Financial Clearance Policy. Documents all estimates, conversations, and collections in EMR.
• Understands and can explain hospital payment options to patients.
• Maintains and updates knowledge regarding all types of insurance and healthcare coverage, utilizing reference materials provided, when necessary.
• Understands and follows all regulatory requirements including but not limited to: Emergency Medical Treatment and Labor Act (EMTALA), Health Insurance Portability and Accountability (HIPAA), and Red Flag Rules.
• Performs alternate provider workflow for not on staff providers including, NPI check and OIG Exclusion List checks. Documents all information in EHR.
• Informs patients of and obtains signatures timely for all registration forms including but not limited to: Conditions of Admission, Guide to Billing and Financial Assistance, Patient Rights and Responsibilities, Notice of Privacy Practices, Acknowledgment of Patient Information on Advance Directives, Important Message from Medicare, and California Observation Notice.
• Creates armbands, labels and other documentation as necessary. Places armbands on patients following appropriate policy and procedure.
• Obtains worker’s compensation accident information when applicable. Calls patient employer to verify employment. Obtains all insurance information from employer timely. Contacts insurance company to gather claim information. Enters all information into EHR.
• Completes Medicare Secondary Payor Questionnaire and documents responses in EHR. Uses EMR to check local coverage determinations for Medicare patients as needed. Generates and produces Advanced Beneficiary Notices (ABN’s). Delivers to patients and documents in EMR.
• Aids patients with filling out medical records release forms. Verifies patient identity and documents on forms. Sends all Release of Information (ROI) forms to Health Information Management (HIM).
• Schedules patients for walk-in services. Assists in scheduling patients at check out.
• Utilizes patient schedules to prepare for patient appointments when possible including but not limited to: missing registration items, patient estimates, forms, schedules, and notes.
• Promptly answers phone calls at work station and directs to appropriate area as necessary. Acts as District operator coverage outside of business hours or as needed.
• Displays exceptional customer service with patients, visitors, and peers at all times by addressing and treating all with respect and understanding.
• Attends and engages in department meetings, projects, teams, trainings, and committees.
• Utilizes interpreter service to communicate with patients when needed.
• Performs quality checks, reports, audits, note-taking, and other clerical tasks for department when requested.
• Completes all job functions with discretion ensuring patient privacy.
• Stores patient’s valuables and documents appropriately.
• Responds to emergency calls and pages emergency announcements in accordance with emergency response policies.
• Performs hospital front desk duties. Receives visitors, obtains name and nature of business, and provides information and direction.
• Works shift and area as assigned on schedule. Is cross trained in different coverage areas of Patient Access when requested.
• Enters safety, feedback, and disruptive event reports as needed.
• Displays critical thinking at all times.
• Actively looks for solutions and shares ideas for improvement with team.
• Maintains proactive and positive communication with management team, peers, and patients at all times.
• Exhibits professionalism in appearance, speech and conduct following department dress policy at all times while on shift.
• Acts as leader of assigned inter-department committee or team. Is responsible for deliverables in moving team forward.
• Works on special projects as assigned.
• Acts as subject matter expert on assigned quality checks, reports, and audits for department.
• Acts as mentor and operational trainer to new team members in conjunction with Registration Coordinators. Trains, validates, and competency checks new team members. Communicates progress of trainee to Supervisors and Registration Coordinators.
• Attends and actively participates in training of operational trainers. Stays current on all training methods and tasks. Participates in continuing education of operational trainers.
• Demonstrates System Values in performance and behavior.
• Complies with System policies and procedures.

Qualifications

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Supervisory Responsibilities: No supervisory responsibilities.

Education And Experience

• No educational requirement and 1 - 2 years of relevant experience.
• Bachelor’s degree in healthcare administration, business administration or related field.
• One to two years patient registration experience.
• Customer Service experience.