Patient Access Rep I - FT - Day - Patient Access Services Trenton NJ

Capital Health (US)

25d•$18 - $23

About The Position

Capital Health is seeking a Patient Access Rep I to register patients accurately, efficiently, and professionally, preserving database integrity and facilitating claims processing. The role applies financial screening guidelines to support collectable accounts and follows established standards, guidelines, and written procedures for registration functions. The representative verifies benefits, insurance, authorizations, and referrals; collects and enters accurate patient and insurance information; obtains signatures; and ensures required forms are scanned into the Electronic Medical Record. The role also assists patients and customers respectfully, collaborates with other departments and provider offices, follows financial screening and regulatory procedures, and participates in department meetings and performance improvement initiatives.

Requirements

High school diploma or equivalency.
One year of experience in a healthcare setting or customer service.
Strong customer service skills.
Excellent verbal and written communication skills.
Strong interpersonal skills.
Basic computer skills.
Ability to work independently and as part of a team.
Ability to maintain composure in a high-pressure or fast-paced environment.

Nice To Haves

Knowledge of medical terminology.
Knowledge of medical insurance.

Responsibilities

Follow payor requirements for in- and out-of-network insurance plans and identify referral and precertification needs according to department procedures.
Verify benefits for patient encounters and audit charts for accuracy.
Use computer systems and third-party insurance applications to obtain accurate demographic, diagnosis, authorization, referral, and insurance information.
Assist patients and customers professionally and respectfully.
Collaborate with departments, physicians, and physician office staff to obtain registration information needed for reimbursement and customer satisfaction.
Comply with department procedures and regulatory guidelines related to Medicare Secondary Payer, Medicare Medical Necessity Regulations, copay collection, Advance Beneficiary Notices, Advance Directives, and Patients’ Rights.
Meet the established minimum patient registration goal per employee shift, as measured by productivity reports.
Identify patients according to policy and complete registration types with accurate patient demographics, physician and insurance information, and registration-specific codes.
Obtain necessary signatures, verify insurance, obtain authorization when needed, scan essential registration forms into the Electronic Medical Record, and perform chart follow-up as needed.
Distinguish and record primary care, referring, and attending physicians appropriately.
Identify participating Capital Health insurance plans and nonparticipating plans.
Use the Insurance Card Database and/or insurance verification guidelines.
Follow Financial Screening and Self Pay procedures, including referrals for Medicaid and Charity Care.
Attend mandatory department meetings.
Support and participate in department performance improvement initiatives.
Perform other duties as needed.