Patient Access Rep II

Emory•Atlanta, GA

About The Position

The Patient Access Rep II assists with the coordination, prioritization, and completion of front-end patient registration activities, from pre-registration through discharge, in the Patient Access Services Department. The representative verifies insurance and ensures requirements are met, completes registrations according to departmental protocols and regulatory standards, and calls patients to pre-register or confirm appointments. The role prioritizes work to support optimal reimbursement and reduce financial risk for patients and the hospital. It includes informing patients of financial liabilities, collecting amounts due when appropriate, identifying patients who need early financial counseling, referring uninsured patients to financial counselors, and escalating unresolved insurance benefit concerns. The representative assists patients, guarantors, and families with insurance questions and maintains the confidentiality of patient and employee information. The position requires a self-motivated person with strong time-management skills who can handle high patient volumes and a fast-paced environment. The representative maintains knowledge of insurance, registration, scheduling, referrals, authorizations, account follow-up, and Patient Access systems. They follow applicable state and federal regulations and communicate issues professionally while contributing ideas for improvement.

Requirements

High school diploma or equivalent.
At least 2 years of healthcare-related or customer service experience; an associate or bachelor's degree may be accepted in lieu of experience.
Typing speed of at least 35 words per minute.
Good communication skills.

Nice To Haves

Knowledge of Medicare, Medicaid, and other commercial payers, including HMO and PPO plans.
Certified Healthcare Access Associate (CHAA) certification.

Responsibilities

Coordinate, prioritize, and complete patient registration activities from pre-registration through discharge.
Verify patient insurance and ensure insurance requirements are met before or on the date of service.
Accurately register patients according to departmental protocols, standards, policies, procedures, and regulatory requirements.
Call patients to pre-register or confirm appointments.
Prioritize work to support optimal reimbursement and avoid financial risk to patients and the hospital.
Inform patients of their financial liability, attempt to collect amounts due as appropriate, and document responses when payment is not collected.
Identify patients needing early financial counseling and refer uninsured patients to a financial counselor as appropriate.
Assist patients, guarantors, and families with insurance questions and escalate unresolved insurance benefit concerns to the department Financial Counselor.
Maintain confidentiality of patient, employee, and other protected information.
Search databases to determine whether a patient is new or established.
Obtain required signatures for release of information and other registration documents in accordance with policy and procedures.
Complete registration by verifying information and insurance for established patients or entering information for new patients before discharge.
Reconfirm patients' dates of birth and legal spelling of their names.
Obtain appropriate signatures and scan required documents, patient identification, and insurance cards.
Distribute registration paperwork according to departmental procedures.
Schedule procedures and follow-up appointments.
Communicate hospital financial policies to patients.
Maintain required monthly assurance accuracy rates and departmental productivity, quality, and collection standards.
Respond promptly and appropriately to verbal and written requests, and communicate issues and concerns constructively and professionally.
Participate in generating ideas and solutions for improvement.