Patient Access Rep - Full Time/Days

Trinity Health•Mason City, IA

About The Position

Provides patient-focused customer service and performs outpatient and/or inpatient registration and insurance verification. The role collects patient financial liability payments and ensures patients meet financial requirements, including Medicare medical necessity, payer pre-certifications, and referrals. It also provides general information to hospital users, patients, families, and physician offices. The position validates, obtains, and enters demographic, clinical, financial, and insurance information into the patient accounting system by interviewing patients, family members, and/or guarantors. Registration activities occur in a variety of settings and for multiple patient types, including inpatients, outpatients, ambulatory surgery, the emergency department, diagnostic outpatients, labor and delivery, newborns, and lab specimens. The representative prepares patient estimates, explains liabilities, collects payments, documents transactions, and provides receipts. Other duties include obtaining physician orders and required signatures, preparing identification bracelets and labels, and potentially auditing and recording patient valuables and obtaining appropriate authorizations.

Requirements

High school diploma or equivalent.
Knowledge of medical terminology, diagnostic coding, and procedural coding.
Ability to explain insurance benefits.
HFMA CRCR or NAHAM CHAA certification required within one year of hire.

Nice To Haves

Hospital registration or insurance verification experience upon hire is preferred.

Responsibilities

Validate, obtain, and enter demographic, clinical, financial, and insurance information into the patient accounting system through interviews with patients, family members, and/or guarantors.
Perform registration activities across various settings and patient types, including inpatient, outpatient, ambulatory surgery, emergency department, diagnostic outpatient, labor and delivery, newborn, and laboratory specimen services.
Prepare patient estimates and explain financial liabilities to patients or guarantors.
Collect co-payments, co-insurance, deductibles, deposits, and outstanding balances at check-in; document payments and actions in the patient accounting system and provide receipts.
Ensure patients meet financial requirements, including Medicare medical necessity, payer pre-certifications, and referrals.
Provide general information to hospital users, patients, families, and physician offices.
Obtain signed physician orders for tests and procedures from physicians or offices.
Prepare patient identification bracelets and ID labels.
Obtain and scan patient or guarantor signatures on required forms, including ID cards, insurance cards, consent to treatment, assignment of benefits, release of information, and waivers.
May audit and record patient valuables and secure appropriate authorizations when needed.