Patient Access Rep - ED/Weekend Baylor

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 the patient, a family member, and/or guarantor. Registration activities take place in a variety of settings and cover multiple patient types, including inpatients, outpatients, ambulatory surgery, emergency department, diagnostic outpatients, labor and delivery, newborn, and lab specimens. The representative prepares patient estimates, explains patient or guarantor liabilities, and collects applicable co-payments, co-insurances, deductibles, deposits, and outstanding balances at check-in. Payments and related actions are documented in the patient accounting system, and receipts are provided. The representative obtains signed physician orders for tests and procedures; prepares identification bracelets and patient ID labels; and obtains or scans required patient and guarantor signatures on forms. The role may also involve auditing and recording patient valuables and securing 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 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 a variety of settings and patient types, including inpatient, outpatient, ambulatory surgery, emergency department, diagnostic outpatient, labor and delivery, newborn, and lab specimen registrations.
Prepare patient estimates and explain patient or guarantor financial liabilities.
Collect applicable co-payments, co-insurances, deductibles, deposits, and outstanding balances at check-in; document payments and actions in the patient accounting system and provide receipts.
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.
May audit and record patient valuables and secure appropriate authorizations.
Provide general information to hospital users, patients, families, and physician offices.
Perform insurance verification and ensure financial requirements are met, including Medicare medical necessity, payer pre-certifications, and referrals.