Patient Access Rep II Registration Services FT Days

Trane Technologies•Detroit, MI

10h

About The Position

Under limited supervision, the Patient Access Rep II serves as a resource to Patient Access Representative I staff, providing training and orientation on department methods, procedures, and policies and offering input on departmental policies and procedures. In conjunction with the Lead, the role resolves complex eligibility and insurance verification problems by contacting patients or their families, government agencies, other hospital departments, and third-party payers. The position also assists Financial Counselors with financial counseling, helps patients identify and obtain payment sources, and recommends actions for complex or sensitive issues. The role supports bed management as defined by operating-unit policies and procedures. It verifies insurance coverage and benefits, obtains and analyzes authorizations and referrals, calculates estimated patient liability, and reviews and reconciles patient accounts for accurate billing and third-party payer compliance. The position registers and schedules patients for health services, confirms that the setting is appropriate, explains required forms, and obtains completed consent, regulatory, and applicable MSP forms and signatures. The Patient Access Rep II obtains accurate insurance, medical, and demographic information for admission or pre-admission; determines and collects copayments and deductibles according to hospital policy; and helps uninsured patients complete medical assistance applications or arrange payment. The role coordinates scheduling of tests and services using current clinical guidelines and serves as a liaison between patients and the health facility by answering questions about facility policies and billing procedures. It collects referrals and authorizations, seeks telephone referrals when needed, completes telephone registrations as appropriate, resolves bill holds within the five-day timeframe, and corrects rejected transactions on user-specific Transmission, Control and Errors (TCE) reports. The position participates in special projects, communicates clinical, financial, and administrative information, performs Lead duties when requested, and carries out other assigned duties.

Requirements

High school diploma; an associate degree in a related area is desired.
Two to three years of progressively more 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 and provide training and orientation on departmental methods, procedures, and policies.
Provide input for establishing departmental policies and procedures.
Resolve complex eligibility and insurance verification problems in conjunction with the Lead, contacting patients or families, government agencies, other hospital departments, and third-party payers as needed.
Assist Financial Counselors with financial counseling and help patients identify and obtain payment sources.
Resolve complex or sensitive issues and recommend appropriate actions.
Participate in bed management in accordance with 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 ensure 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 for patient admission or pre-admission.
Determine patient copayments and deductibles and collect payments according to hospital policy.
Assist uninsured patients with medical assistance applications and payment arrangements, and collect cash payments.
Coordinate scheduling of tests and services using current clinical guidelines.
Answer patient questions about facility policies and billing procedures and obtain information needed for efficient 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 within the five-day timeframe and 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.