Patient Access Representative I - Huntington Beach

City of Hope•Huntington Beach, CA

About The Position

The Patient Access Representative I checks patients in and out on behalf of medical group physicians and other licensed providers. The position independently coordinates patient appointments across multiple hospital departments and uses telecommunications and computer information systems to create accounts, verify patient and insurance information, collect co-pays, and schedule or reschedule complex appointments. The representative may work across different patient care areas, supports the patient experience, communicates between physicians and patients, and serves as an information resource. The role manages patient registration and scheduling in paper and electronic environments, including registration, preregistration, consents, appointments, legal documents, and related records. It coordinates appointments with other functional areas and maintains department productivity, accuracy, and quality standards. Financial access duties include reviewing account documentation, verifying insurance eligibility and authorizations, collecting payments, providing pricing estimates and financial assistance information, and escalating unresolved financial issues. The representative also provides patients with relevant itineraries and instructions, supports financial clearance, and coordinates diagnostic test orders and authorizations. The representative provides customer service to patients and visitors and serves as a liaison between patients and support staff. The role requires effective communication and collaboration across the organization, the ability to manage changing priorities and stressful situations professionally, and appropriate escalation of issues affecting patient care. It also includes maintaining knowledge of departmental policies and procedures and performing other assigned administrative and departmental duties.

Requirements

High school diploma or equivalent.
One year of experience in a high-volume customer service-related field with direct interaction with customers.

Responsibilities

Check patients in and out on behalf of medical group physicians and other licensed providers.
Coordinate, schedule, and reschedule patient appointments across multiple hospital departments and care areas.
Create patient accounts and verify demographic and insurance information using telecommunications and computer information systems.
Register and preregister patients, obtain consents, link preregistration records and encounter types to scheduled appointments, and complete required legal documentation.
Coordinate appointments with other functional areas and maintain department productivity, accuracy, and quality standards.
Collect co-pays and other payments, provide patient pricing estimates, and perform other cash collection functions.
Review account documentation, verify insurance eligibility, confirm authorizations, and escalate unsecured financial accounts to management.
Provide patients with itineraries, advance beneficiary notices, written instructions for tests and procedures, and information about financial assistance and its application process.
Provide financial assistance applications to uninsured patients and seek help from Financial Counselors as needed to maintain patient flow and financial clearance.
Screen ordered tests and communicate tests or diagnoses that may not meet Medicare coverage criteria to physicians or the ABN Specialist.
Request service authorizations when applicable and send diagnostic test orders to the appropriate department with documentation of the service date and visit number.
Greet and assist patients and visitors, serve as a liaison between patients and support staff, and communicate with colleagues, physicians, providers, leaders, and other employees.
Manage changing priorities, respond professionally to difficult situations, recognize high-priority situations, take appropriate action, and escalate unresolved issues according to departmental guidelines.
Maintain knowledge of departmental policies, procedures, and standard work, and meet applicable productivity and accuracy standards.
Perform other assigned departmental duties, including calls, faxes, document filing, supply inventory, and data entry.