Patient Access Rep - PRN

Trinity Health•Lavonia, GA

About The Position

This part-time, PRN 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. Weekly work hours vary. The position requires open availability for mornings, evenings, weekends, and possibly overnights, and availability to work 12-hour shifts. The role supports Trinity Health’s mission, values, vision, actions, and promise. Work may include researching and analyzing information, identifying opportunities and solutions, contributing to performance improvement, and distributing analytical reports. The position uses multiple system applications to perform analysis, create reports, and develop educational materials, while following applicable policies and procedures and prioritizing quality, confidentiality, and safety. The description outlines several functional role levels. PAR I is an entry-level role. PAR II performs PAR I duties and is cross-trained in Pre-Service, the Emergency Department, and/or Bed Desk. A Patient Access Account Specialist uses specialized knowledge and data analysis to support organizational objectives, may direct a project or project team, reviews and edits work for correctness under payer guidelines, resolves items to ensure accurate billing, and processes payments timely. There are no benefits aligned with this position.

Requirements

High school diploma or equivalent.
HFMA CRCR or NAHAM CHAA certification required within one year of hire.
Minimum one year of customer service experience for PAR I.
For PAR II, minimum two years of hospital registration or insurance verification experience upon hire.
For PAR II, knowledge of medical terminology and diagnostic and procedural coding, and ability to explain insurance benefits.
For the Patient Access Account Specialist function, at least two years of hospital registration or insurance verification experience.
Availability to work mornings, evenings, weekends, and possibly overnights.
Availability to work 12-hour shifts.
Customer service experience.
Strong computer skills.

Nice To Haves

Patient Access experience preferred.
Healthcare experience is a plus.
Medical terminology and knowledge of diagnostic and procedural coding.
Insurance verification experience, ability to explain benefits, and ability to secure necessary authorization.

Responsibilities

Provide patient-focused customer service.
Perform outpatient and/or inpatient registration and insurance verification.
Collect patient financial liability payments.
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.
Research, collect, and analyze information; identify opportunities; develop solutions; and lead issues through resolution.
Collaborate on performance improvement activities related to program efficiency and patient experience.
Distribute analytical reports.
Use system applications to perform analysis, create reports, and develop educational materials.
Research and compile information for ad hoc operational projects and initiatives.
Synthesize and analyze data, prepare detailed summaries and graphical presentations, identify trends, and recommend practical options or solutions.
Use program and operational data and measurements to demonstrate progress, ROI, and impacts.
For PAR II, perform PAR I activities and cross-train in Pre-Service, the Emergency Department, and/or Bed Desk.
For the Patient Access Account Specialist function, analyze, process, and edit work for correctness based on payer guidelines; resolve items; ensure claims are billed accurately; and process payments timely.
Maintain working knowledge of applicable laws, regulations, and organizational policies, procedures, and guidelines; adhere to ethical, professional, and safe work practices.