Patient Access Rep II - FT - Day - Patient Access Services Lawrenceville NJ

Capital Health•Hopewell, NJ

2d•Onsite

About The Position

Capital Health is seeking a Patient Access Rep II for a full-time, day shift position in Patient Access Services in Lawrenceville, NJ. This role is responsible for accurate and efficient patient registration, maintaining financial integrity of front-end registration and insurance verification, and ensuring customer satisfaction. The representative will apply financial screening guidelines, stay updated on payor and regulatory guidelines for medical insurance claims, and develop relationships with physician offices, acting as a liaison. The position requires a high school diploma or equivalent, with experience requirements including either six months in a Patient Access Rep I role at Capital Health or one year of customer service experience with medical terminology. Proficient computer skills, familiarity with medical terminology, and knowledge of insurance plans are necessary. The role demands excellent communication, interpersonal, and organizational skills, with the ability to problem-solve, multitask, and manage frequent interruptions. The representative must maintain composure in high-pressure or fast-paced environments and be able to work independently and as part of a team.

Requirements

High school diploma or equivalent.
Six months in Patient Access Rep I role at Capital Health or one year customer service experience with medical terminology.
Proficient computer skills.
Familiar with medical terminology.
Excellent communication, interpersonal and organizational skills.
Ability to problem solve and multitask and manage frequent interruption.
Expert and current knowledge of all aspects of insurance requirements.
Ability to work independently and as a team.
Maintains composure in high pressure or fast-paced environment.

Nice To Haves

A quality of knowledge of insurance plans and insurance experience preferred.

Responsibilities

Registers patients accurately, efficiently, and independently to ensure database integrity.
Maintains financial integrity of all front-end registration and insurance verification functions while upholding the utmost in customer satisfaction.
Applies all financial screening guidelines and maintains up-to-date knowledge and adheres to all payors and regulatory guidelines for medical insurance claims for processing and reimbursement.
Develops and maintains solid relationships with physician offices and functions as a liaison between offices at Capital Health.
Identifies participating and non-participating CH insurance plans.
Demonstrates service excellence by professionally assisting patients and customers with the utmost respect in a friendly, caring manner.
Registers patients quickly and accurately, exceeding productive levels of a Patient Access Rep I.
Correctly identifies a patient according to policy, completes all patient registration types by collecting and entering accurate patient demographics, physician information, insurance information, and valid registration-specific codes.
Obtains all necessary signatures.
Assures insurance information is verified, and authorization is obtained if not done prior to the service.
Scans essential registration forms into EMR and performs chart follow-up.
Performs all job duties independently with minimal supervision.
Follows all payor requirements and identifies needs for referrals and precertification.
Performs verification of benefits on all patient encounters.
Reviews chart for accuracy.
Follows computer system, internet-based insurance applications, and department operational procedures and training guidelines to obtain accurate demographic, diagnosis, authorizations/referrals, and insurance information on each registration.
Works collaboratively with other departments, physicians, and physician office staff to obtain essential registration information such as insurance authorization, referrals, diagnosis and scripts to secure financial reimbursement and customer/patient satisfaction.
Complies with department procedures and regulatory guidelines for Medicare Secondary Payer, Medicare Medical Necessity Regulations, Collection of co-pay, Advance Beneficiary Notice, Advance Directives and Patient's Rights.
Ascertains and records appropriately the difference between primary care physician, referring physician, and attending physician.
Utilizes Insurance Card Database and/or Insurance Verification guidelines.
Follows Financial Screening and Self Pay Procedure with regards to referrals for Medicaid and Charity Care.
Assists and supports with staff departmental training.
Attends all mandatory department meetings.
Supports and participates in department performance improvement initiatives.
Performs other duties as needed.