Patient Access Representative - South Park - Days

About the role

The Patient Access Representative delivers high-quality customer service to patients of all ages, their families, visitors, medical staff, clinicians, and co-workers, ensuring all interactions are courteous, timely, and respectful.

Responsibilities

• Greet Patients/Answer Telephone
• Provides exceptional customer service by welcoming patients and visitors in a friendly, professional, and respectful manner.
• Ensures individuals are respected and informed, communicating clearly and effectively, and utilizing appropriate language resources as needed.
• Assists with traffic flow in and out of the clinic as needed.
• Addresses patient needs promptly, and maintains a courteous, professional tone at all times.
• Co-payment Collection & Registration Data
• Collections all patient co-payments and deposits accurately per payer, following department guidelines.
• Verifies and updates registration data, including demographic and insurance information.
• Copies and records insurance information per department standards.
• Follows department policies for cash handling, including cash reconciliation and deposit preparation.
• Referral Management
• Verifies insurance coverage and understands requirements for HMO, managed care, government and private plans.
• Secures required referrals/authorizations and links them correctly in the referral module.
• Obtains needed referrals and authorizations before scheduled procedures, tests, injections, and surgeries.
• Communicates plan-specific referral/authorization requirements to patients and providers.
• Provides pre-payment guidance for self-pay patients and offers financial assistance.
• Prepares cost estimates, explains payment expectations, and documents all interactions in the patient account.
• Appointment Scheduling, Lab & Test Order Entry
• Correctly schedules clinic appointments through the medical records software/communication platform.
• Transcribes physician orders accurately and completely (i.e. lab test, ancillary test) and records them in the appropriate system(s) according to the physician’s instructions and VCUHS policy.
• Captures and coordinates the collection of pre-operative testing and paperwork, where appropriate.
• Patient Record/Verify Registration Data
• Maintains proficiency in all aspects of patient medical record keeping in an organized manner.
• Aids in preparing the chart before the patient visits.
• If applicable, assists in breaking down the chart at the completion of the patient's visit.
• Ensures that all patients arrived in the appointment scheduling system before the end of the appointment day.
• Where appropriate, appointments are documented as “no-shows” or cancellations before the end of the appointment day.
• Obtains signatures and completes the required forms including those from managed care and other insurance plans.
• E-Documents Management & Scanning
• Obtains and scans all appropriate patient medical documentation.
• Miscellaneous Responsibilities
• Notifies supervisor of issues involving violation of VCUHS policies or procedures.
• Performs other duties as assigned and/or participates in special projects to support the mission of VCUHS and department.

Qualifications

• Education Required: High School Diploma or equivalent
• Education Preferred: Associates or Bachelor’s Degree in Accounting, Finance, Business Administration, Healthcare Administration or closely related field from an accredited program.
• Licensing/ Certification Licensure Required: N/A
• Licensure Preferred: N/A
• Certification Required: N/A
• Certification Preferred: N/A
• Minimum Qualifications: Years and Type of Required Experience: Demonstrated experience using computers, Microsoft Office applications, and web-based platforms
• Experience Preferred: Work experience with medical insurance, HMO, managed care, electronic medical billing/order entry/registration systems, and appointment scheduling.
• Previous work experience in a healthcare setting, and knowledge of medical terminology.
• Other Knowledge, Skills and Abilities Required: Able to perform daily activities with minimal supervision: being self-directed in the accomplishment of routine activities.
• Other Knowledge, Skills and Abilities Preferred: Depending on assignment, may be required to work off-shifts and/or weekend and holidays.
• Working Conditions: Periods of high stress and fluctuating workloads may occur. General office environment. May have periods of constant interruptions. Prolonged periods of working alone.