ED Outpatient Patient Access Rep PRN - Gainesville & Cumming

Northeast Georgia Health System•Gainesville, GA

About The Position

Under the supervision of the Patient Access Supervisor, the Patient Access Rep provides customer service and completes patient registration. The role gathers and verifies demographic, subscriber, and insurance information; determines eligibility and benefits; confirms pre-certification; identifies patient financial responsibility; collects applicable payments; and provides financial counseling or referrals when appropriate. Registration information and related documents are recorded or scanned into the appropriate systems, and the employee completes the full registration process for scheduled and unscheduled outpatient visits, including ED registration as applicable.

Requirements

High school diploma or GED.
Proficiency using office equipment, including a computer, fax, telephone, and scanning copier.
Ability to move around the hospital campus and push a patient in a wheelchair if necessary.
Ability to work independently, demonstrate emotional maturity, and function effectively under stress while maintaining a positive attitude with patients.
Excellent problem-solving and analytical skills.
Working knowledge of Protected Health Information.
Ability to be flexible and manage change, with excellent written and oral communication skills.
Proficiency with Patient Access systems, software applications, and processes.
Knowledge of billing requirements and proper documentation.
Detailed understanding of insurance guidelines and protocols, verification components, and payer information and requirements.

Nice To Haves

Bilingual ability.
Associate or bachelor's degree in business or a financial/healthcare-related field.
Experience with medical terminology, data entry, computers, admitting, business offices, collections, physician offices, or working with the public.

Responsibilities

Greet and assist patients while delivering outstanding customer service.
Capture and document complete patient demographic, subscriber, and insurance information, including policy and ID numbers, guarantor and payer details, and applicable coverage and cost-sharing information.
Obtain insurance information and verify eligibility and benefits by contacting patients, physician offices, and insurers or payers.
Review registration work for accuracy, including patient and visit type, code identification, insurance, and demographic information.
Assess and collect applicable patient financial liabilities before service, explain the facility billing process, refer patients for financial counseling when appropriate, and document payments.
Scan insurance cards, identification, physician orders, consent forms, and other relevant registration documents into the Document Management System.
Search Patient Access Systems for existing patient history to avoid duplicate medical records.
Confirm and update pre-certification information in the EHR for scheduled and unscheduled outpatient accounts as applicable.
Perform medical necessity checks when applicable and complete an ABN form when medical necessity requirements are not met.
Obtain and complete MSP forms when applicable.
Explain and complete registration consents and other documents with patients as needed.
Prepare patient packets for the next day's scheduled procedures, as applicable to the area.
Follow standard operating procedures during EHR or other system downtime.
Coordinate with physician offices and other departments to support patient satisfaction.
Use Patient Access systems and processes appropriately and meet departmental goals for productivity, accuracy, collections, and customer satisfaction.
Maintain positive, professional oral and written communication and perform related duties assigned by management.