PATIENT ACCESS REPRESENTATIVE (ED & ADMISSIONS)

FDIHB•Fort Defiance, AZ

8h•Onsite

About The Position

This position is responsible for providing high-quality customer service to both external and internal customers in a healthcare setting. The role involves greeting patients, families, and visitors, verifying appointment information, providing directions, and responding to inquiries. Key duties include interviewing new patients to determine eligibility, building patient health records in the database, performing registration and check-in processes, entering data, providing necessary forms, obtaining signatures, and generating population health summaries. The role also requires verifying insurance eligibility, assisting with pre-certification, referrals, and authorizations, and reviewing patient registration information for accuracy. Additionally, the Patient Access Representative checks patients into the clinic electronically, participates in departmental training and quality assurance programs, initiates new health records, requests eligibility documents, resolves discrepancies in claims processing, schedules follow-up appointments, and faxes documents and records to other facilities or providers. Other duties as assigned.

Requirements

One (1) year of direct work experience in registration, scheduling, screening or customer service.
High School Graduate or Equivalency (HSE)
Valid, unrestricted insurable driver’s license
Resumes and references are required

Nice To Haves

Navajo/Indian Preference: Applicants who meet the minimum qualifications for this position and who are enrolled members of the Navajo Nation will be given primary preference in hiring and employment. Members of other federally recognized Indian tribes will be given secondary preference. Other candidates will be considered only after all candidates entitled to primary or secondary preference have been fully considered.

Responsibilities

Provides high-quality customer service to both external and internal customers that meets or exceeds the service standards of the health care industry.
Greets all patients, families and visitors, verifies appointment information, provides directions and responds to inquires as appropriate.
Interviews new patients to determine eligibility, adds to database as appropriate to build patient health record.
Performs registration/check-in processes, including but not limited to performing data entry activities, providing patients with appropriate information and intake forms, obtaining necessary signatures and generating population health summary.
Verifies insurance eligibility for services rendered with the payers and documents appropriately.
Assists in obtaining or validating pre-certification, referrals, and authorizations.
Reviews patient registration information for updates and/or changes to primary and secondary insurance coverage to ensure accuracy of billing.
Checks patient into the clinic via the electronic record to acknowledge the patient has arrived for an appointment or is requesting to be evaluated and to generate a visit record for the patient.
Participates in departmental orientation, on the job training and quality assurance programs/initiatives.
Interviews patients to obtain information to initiate a new health record and communicates to Health Information Management when record reactivation is required.
Requests for tribal enrollment and other eligibility documents for verification to ensure coverage.
Determines sources of discrepancy or reasons for denial and implements corrective action as appropriate to ensure that the claims can be processed for payment.
Schedules appointments for patients needing following up in the clinic or specialty areas.
Performs or actively facilitates faxing of appropriate documents and records to other facilities or other medical providers.
Performs other duties as assigned.