Patient Access Rep II

Emory Healthcare•Johns Creek, GA

1d•$19 - $23

About The Position

A Patient Access Rep II coordinates, prioritizes, and completes front-end patient registration activities, from pre-registration through discharge, within the Patient Access Services Department. The role verifies insurance and ensures registration and payer requirements are met, following departmental standards and applicable regulations. The representative may call patients to pre-register or confirm appointments, schedule procedures and follow-up appointments, communicate hospital financial policies, explain patient financial liability, and make appropriate collection efforts. The position supports patients, guarantors, and families with insurance questions and escalates unresolved insurance benefit concerns to a department Financial Counselor. It identifies patients who may need early financial counseling and refers uninsured patients to a financial counselor as appropriate. The representative maintains confidentiality, handles high patient volumes in a fast-paced environment, and supports the EHC Patient Access Mission Statement. The role requires familiarity with insurance, registration, scheduling, referrals, authorizations, account follow-up, and multiple Patient Access system applications. It also involves accurate database searches and registration documentation, obtaining required signatures, scanning identification, insurance cards, and other documents, and distributing paperwork according to departmental procedures. The representative is expected to communicate professionally, respond promptly to requests, contribute ideas for improvement, and meet departmental standards for accuracy, productivity, quality, and collections. The work environment and exposures may vary by assigned area and tasks. Potential exposures include blood-borne pathogens, biohazardous waste, chemicals or fumes, communicable diseases, electrical shock, varied floor surfaces and temperatures, indoor and outdoor conditions, latex, patient-care or handling injuries, and radiation. Travel may be required, and personal protective equipment, including respirators, may be used.

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.
Ability to manage time, work independently, and handle high patient volumes and a fast pace.
Ability to maintain confidentiality and follow departmental protocols and regulatory requirements.
Ability to meet the physical demands described, including lifting and carrying up to 25 pounds.

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 front-end patient registration activities from pre-registration through discharge.
Verify patient insurance and ensure insurance requirements are met prior to or on the date of service.
Complete accurate patient registrations according to departmental protocols, 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 financial liability, attempt to collect amounts due, and document when liability is not collected.
Identify patients requiring 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, and reconfirm date of birth and legal spelling of the patient's name.
Obtain required signatures, including releases of information, and scan appropriate registration documents, patient identification, and insurance cards.
Complete registration through verification or entry of patient and insurance information prior to discharge.
Distribute registration paperwork according to departmental procedures.
Schedule procedures and follow-up appointments.
Communicate hospital financial policies to patients.
Maintain the department's required monthly assurance accuracy rate and established productivity, quality, and collections standards.
Maintain knowledge of insurance, registration, scheduling, referrals, authorizations, account follow-up, and Patient Access system applications.
Communicate issues and concerns constructively and professionally, respond promptly to verbal and written requests, and participate in improvement ideas and solutions.
Perform duties in support of the EHC Patient Access Mission Statement and adhere to applicable state and federal regulations and guidelines, including EMTALA, CMS, HIPAA, and JCAHO.