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. Collects patient financial liability payments and ensures patients meet financial requirements, including Medicare medical necessity, payer pre-certifications, and referrals. Provides general information to hospital users, patients, families, and physician offices. The role 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 take place across multiple settings and 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 to patients or guarantors, and collects applicable payments at check-in, including co-payments, co-insurances, deductibles, deposits, and outstanding balances. Payments and related actions are documented in the patient accounting system, and receipts are provided. The role also obtains signed physician orders, prepares identification bracelets and patient ID labels, and obtains or scans required patient and guarantor signatures. Patient valuables may be audited and recorded, with appropriate authorizations secured when needed. The schedule is Monday through Wednesday, 0700–1930, on a 12-hour day shift.

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 by interviewing patients, family members, and/or guarantors.
Perform registration activities in varied settings for multiple patient types, including inpatients, outpatients, ambulatory surgery, emergency department, diagnostic outpatients, labor and delivery, newborns, and lab specimens.
Prepare patient estimates and explain patient or guarantor liabilities.
Collect co-payments, co-insurances, 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.
Obtain signed physician orders for tests and procedures from physicians or offices.
Prepare identification bracelets and patient ID labels.
Obtain or scan patient and guarantor signatures on required forms, including ID cards, insurance cards, consent to treatment, assignment of benefits, release of information, and waivers.
As needed, audit and record patient valuables and secure appropriate authorizations.
Provide general information to hospital users, patients, families, and physician offices.