Patient Access Rep I- Neurosciences
About The Position
This position completes the financial clearance process within Patient Access Services and creates the first impression of WTH’s services for patients, families, and other external customers. The representative explains information clearly so patients, guarantors, and family members understand what to expect and their financial responsibilities, and collects and documents information on the patient’s behalf. Responsibilities may include pre-registration and registration, insurance and benefits verification, certification, referral management, patient-liability collections, medical-necessity checks, financial screening, and obtaining treatment authorizations. The representative works with patients and guarantors, medical staff, nursing, ancillary departments, insurance payers, and other external sources to help families obtain healthcare and financial services.
Requirements
- High school graduate or equivalent.
Nice To Haves
- 1–2 years of healthcare or related experience preferred.
Responsibilities
- Maintain department best-practice routines and keep daily work queues and correspondence current in accordance with department policies.
- Interview patients and collect and record information needed for pre-registration and registration.
- Assign the appropriate insurance payer plan choice and billing address in the automated patient accounting system, and verify relevant group and identification numbers.
- Complete registration according to established policies and procedures.
- Inform families with inadequate insurance coverage about government and financial assistance programs.
- Conduct initial financial screening and refer accounts for financial counseling or appropriate eligibility assessments.
- Ensure referrals and treatment authorizations are obtained for all patient types; contact payers for approval when needed.
- Complete initial medical-necessity checks and refer cases to the designated area if medical necessity fails or referrals or authorizations are denied.
- Advise the next-level leader of possible postponement or deferral of elective or non-emergent admissions that have not been approved before the service date.
- Maintain accurate files for pre-processing information.
- Investigate, resolve, and document patient problems in a timely and efficient manner.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
