Patient Access Representative Sr

About the role

This position's primary role includes performing duties outlined in the Patient Access Representative job description and supporting the work of Patient Access Departments. Among other duties, this individual provides department education, performs registration audits, and creates/maintains standard work as designated by Patient Access Leaders. This role is also responsible for coordinating representatives' efforts to resolve complex accounts and ensuring representatives' interactions with patients are consistent and compassionate during the registration.

Responsibilities

• Conducting a comprehensive registration with minimal assistance, in person or by phone.
• Identifying all potential payer sources, including federal, state and county assistance programs, which will ensure reimbursement for the services being rendered.
• Ensuring this process is expeditious, non-imposing, and insurance authorizations completed meeting payer requirements.
• Timely coordination and accurate relay of information pertaining to patient admissions and insurance authorizations and potential denials by payers.
• Overcoming roadblocks and prioritizing workload to ensure accounts are financially secured and analyzed to identify delays.
• Using diplomacy in communicating effectively to patients, guardians, family members, physicians, and co-workers.
• Cooking with interdisciplinary teams to ensure a seamless registration process.
• Acting as a primary resource for patient de-escalation and service recovery.
• Performing technical aspects of work (80%) within team area of responsibility while prioritizing time (20%) to allow for:
• Developing team members through group, as well as one-on-one, training and in-services.
• Facilitating, implementing, monitoring, and appropriately reacting to quality assurance mechanisms (JACHO).
• Monitoring and developing workflows to improve Patient Experience.
• Developing and revising procedures relevant to the assigned area, coordinated with other Patient Access teams.
• Conducting registration audits and sharing results with representatives and department leadership; works with representatives to improve performance as necessary.
• Working with Patient Access Leadership to resolve operational issues.
• Communicating and tracking of progress towards meaningful goals.
• Ensuring patient financial liabilities are being properly estimated and provided to the patient.
• Producing education for Patient Access personnel to improve on financial collection techniques.
• Participating in and/or assisting with quality management processes.
• Working with Patient Access Leadership on department projects.
• Acting as a resource for day-to-day operational questions.
• Serving as customer service resource for walk-in patients in hospital lobby/patient registration area.
• Maintaining a thorough understanding of federal and state regulations, payer requirements, and third-party financial assistance programs.
• Having sufficient understanding of insurance protocols for referrals, co-payments, deductibles, allowances, etc., and analyzing information received to determine patients' out-of-pocket liabilities.
• Training and performing on-boarding of newly hired employees.

Requirements

• Completion of level 1 from the Retention and Development Program, "LEVL UP" preferred.
• Active CHAA Certification preferred.
• Thorough knowledge and proficiency with MS Excel and MS Word.
• Experience in acute hospital, surgical center, or outpatient center preferred.
• Typing skills of 35-45 words per minute.