Patient Access Representative I - FT - Day - Patient Access Services Trenton NJ

Capital Health (US)

1d•Onsite

About The Position

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region. Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates. The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Requirements

High school diploma or equivalency.
One year experience in healthcare setting or customer service.
Medical terminology and medical insurance knowledge preferred.
Basic computer skills.
Ability to work independently and as a team.
Maintains composure in high pressure or fast-paced environment.

Nice To Haves

Medical terminology and medical insurance knowledge preferred.

Responsibilities

Registers patients accurately, efficiently and professionally to ensure database integrity and facilitate claims processing.
Applies financial screening guidelines to ensure collectable accounts.
Utilizes standards, guidelines, and written procedures for performing registration functions.
Follows all payor requirements for both in/out of network insurance plans and identifies needs for referrals and precertification either electronically or by telephone according to department procedures and guidelines.
Performs verification of benefits on all patient encounters.
Audits chart for accuracy.
Follows computer system, internet-based third-party insurance applications, department operational procedures and departmental training guidelines to obtain accurate demographic, diagnosis, authorizations/referrals and insurance information on each registration.
Demonstrates service excellence by professionally assisting patients and customers with the utmost respect in a friendly caring manner.
Works collaboratively with other departments, physicians and physician office staff to obtain essential registration information such as insurance authorization, referrals, diagnosis, and scripts, to secure financial reimbursement and customer/patient satisfaction.
Complies with department procedures and regulatory guidelines for Medicare Secondary Payer, Medicare Medical Necessity Regulations, Collection of co-pay, Advance Beneficiary Notice, Advance Directives, and Patients’ Rights.
Registers established goal of minimum required patients per employee shift as measured by productivity reports.
Correctly identifies a patient according to policy, completes all patient registration types by collecting and entering accurate patient demographics, physician information, insurance information and valid registration specific codes.
Obtains all necessary signatures.
Assures insurance information is verified, and authorization is obtained if not done prior to service, essential registration forms are scanned into Electronic Medical Record, and chart follow up is performed as needed.
Ascertains and records appropriately the difference between primary care physician, referring physician and attending physician.
Displays comprehension of identifying participating CH insurance plans and ability to identify nonparticipating plans.
Utilizes Insurance Card Database and/or Insurance Verification guidelines.
Follows Financial Screening and Self Pay Procedure with regards to referrals for Medicaid and Charity Care.
Attends all mandatory department meetings.
Supports and participates in department performance improvement initiatives.
Performs other duties as needed.