Patient Access Representative - Sierra Rose Primary Care

About the Role

This position performs all registration, scheduling, order entry, and reception functions, and may float to various admitting sites within the health system. The role facilitates healthcare access by accurately gathering demographic, sponsorship or guardian data, insurance, clinical, financial, and statistical information from patients, families, physicians, physician office staff, county/governmental agencies, CMS, and FMS. The position ensures reimbursement for services rendered through verification of insurance eligibility/benefits, obtaining insurance authorization, identifying and collecting patient financial obligations, and accurate charge order entry. The role also aims to make the admission process comfortable and pleasant for patients and their families.

Responsibilities

• Accurately gather and enter demographic, clinical, and financial information into computer systems.
• Explain and obtain signatures on admission, clinical, and financial forms.
• Collect accident information and identify all insurance payer sources.
• Verify insurance eligibility and obtain insurance notification within required time frames.
• Process charge order entry and determine estimated costs for services rendered.
• Identify and collect patient financial obligations, such as co-payments, co-insurance, and deductibles.
• Document all collected information timely and in accordance with department requirements.
• Refer patients to appropriate federal, state, or county assistance agencies when financial need is identified.
• Perform scheduling, order entry, and reception functions, and assist in completing departmental tasks.
• Solve problems following established company guidelines.
• Maintain confidentiality and comply with standards set by The Joint Commission and HIPAA.
• Use professionalism and diplomacy when interacting with patients, families, physicians, and other healthcare providers.

Skills

• Diplomacy and effective communication during stressful situations.
• Ability to anticipate customer needs and adjust performance style as necessary.
• Working knowledge of healthcare insurance, including documenting subscriber information and determining payer order sequence.
• Knowledge of governmental programs billing requirements.
• Ability to identify patient financial obligations and follow procedures for point-of-service collections.
• Order entry and above-average computer application skills.
• Ability to follow verbal and written instructions.
• Scheduling skills adaptable to a fast-paced environment with heavy physician/physician office staff interaction.
• Flexibility to adapt to different admitting department locations and prioritize/multitask in a fast-paced environment.

Qualifications

Education: Working-level knowledge of the English language (reading, writing, speaking). High School Diploma or GED preferred.

Experience: Six months of admitting, medical claims processing, professional office experience, and/or customer service experience with financial interaction. One year preferred. Experience with Windows Operating systems, SMS InVision, Internet, and SMS IMS Document Imaging is also preferred.

Computer/Typing: Must possess, or be able to obtain within 90 days, the computer skills necessary to complete online learning requirements, access online forms and policies, and complete online benefits enrollment.