Patient Access Rep II Radiology FT Days

Trane Technologies•Commerce Charter Township, MI

About The Position

The Patient Access Rep II works under limited supervision and serves as a resource to Patient Access Representative I staff. The role provides training and orientation on department methods, procedures, and policies, and contributes input to departmental policies and procedures. In coordination with the Lead, the representative resolves complex eligibility and insurance verification issues by communicating with patients or their families, government agencies, other hospital departments, and third-party payers. The position also assists the Financial Counselor with financial counseling, helping patients identify and obtain payment sources, and resolves complex or sensitive issues with appropriate recommendations. The representative registers and schedules patients for health services, confirms that the setting is appropriate, obtains accurate insurance, medical, and demographic information, and ensures required forms, consents, regulatory documents, and signatures are completed. Responsibilities include verifying coverage and benefits, obtaining authorizations and referrals, estimating patient liability, determining and collecting copayments and deductibles, and assisting uninsured patients with medical assistance applications, payment arrangements, and cash collections. The role coordinates tests and services using current clinical guidelines and answers questions about facility policies and billing procedures. The representative reviews, monitors, and reconciles patient accounts for accurate billing and compliance with payer requirements. The role resolves bill holds within the five-day timeframe, reconciles and corrects rejected transactions on user-specific Transmission, Control and Errors (TCE) reports, participates in bed management as established by operating-unit policies, assists with special projects, communicates clinical, financial, and administrative information, and performs Lead duties when requested.

Requirements

High school diploma; an associate degree in a related area is desired.
Two to three years of progressively responsible experience in patient access, hospital registration, or a related area.
Advanced knowledge of third-party payer requirements, reimbursements, and copayment and deductible collections.

Nice To Haves

Associate degree in a related area.

Responsibilities

Serve as a resource to Patient Access Representative I staff.
Train and orient staff on department methods, procedures, and policies.
Provide input on departmental policies and procedures.
Resolve complex eligibility and insurance verification problems in conjunction with the Lead, contacting patients or families, government agencies, hospital departments, and third-party payers as needed.
Assist the Financial Counselor with financial counseling and help patients identify and obtain payment sources.
Resolve complex or sensitive issues and recommend appropriate actions.
Participate in bed management according to operating-unit policies and procedures.
Verify insurance coverage and benefits, obtain and analyze authorizations and referrals, and calculate estimated patient liability.
Review, monitor, and reconcile patient accounts to support accurate billing and compliance with third-party payer requirements.
Register and schedule patients for health services and ensure the setting is appropriate for the services provided.
Explain forms to patients and families and ensure required consent, regulatory forms, and applicable MSP questionnaires are completed and signed.
Obtain accurate insurance, medical, and demographic information to admit or pre-admit patients.
Determine patient copayments and deductibles and collect payments according to hospital policies.
Help uninsured patients complete medical assistance applications, arrange payments, and make cash collections.
Coordinate scheduling of tests and services using current clinical guidelines.
Answer patient questions about facility policies and billing procedures and obtain information needed for registration and accurate billing.
Assist patients with required forms and obtain signatures.
Collect referrals and authorizations and attempt to secure telephone referrals when necessary.
Complete telephone registrations as appropriate.
Resolve bill holds in a timely manner to meet the five-day bill hold timeframe.
Reconcile and correct rejected transactions on user-specific Transmission, Control and Errors (TCE) reports.
Assist with and participate in special projects as assigned.
Communicate clinical, financial, and administrative information.
Perform Lead duties when requested and other duties as assigned.