Patient Access Representative I

Trinity Health•Westerville, OH

9d•Onsite

About The Position

The Patient Access Representative I, also described as Patient Financial Specialist I, ensures accurate and complete patient registration and admission information and completes required forms. The role collects deductibles, co-pays, coinsurance, deposits, and other payments; gathers and evaluates confidential patient financial data to assess eligibility for financial assistance and patient financial responsibility; and helps resolve billing questions. The representative serves as an information resource for other departments and physician offices and establishes payment arrangements based on patients’ account histories. The position requires understanding how diagnoses and procedures relate to CPT and ICD-9 coding, third-party reimbursement methodologies, and Medicare, Medicaid, and other payer requirements. The representative follows applicable third-party rules and legislation governing medical and financial information, debt collection, and credit reporting, and abides by the department’s service vision. The role is in the Emergency Room specialty and includes patient registration, insurance verification, patient communication, soft collections during registration, and use of EPIC.

Requirements

High school diploma or GED required.
Demonstrated experience may be used in lieu of a degree.
Working knowledge of Medicare, Medicaid, and other third-party information requirements and regulations.
Working knowledge of third-party payer benefits and requirements and regulations affecting registration procedures.
Working knowledge of CPT and ICD-9 coding and payer reimbursement methodologies.

Nice To Haves

Associate’s degree in Healthcare Administration, Business Administration, or a related field preferred.
At least three years of experience preferred in a physician’s office, clinic, hospital business office, financial service setting, or related area involving public-facing collection of data and funds.

Responsibilities

Register patients and ensure accurate and complete registration or admission information and required forms.
Verify insurance and apply knowledge of third-party benefits, requirements, and regulations affecting registration.
Collect patient deductibles, co-pays, coinsurance, deposits, and other payments, including soft collections during registration.
Gather and evaluate confidential patient financial information to determine financial assistance eligibility and patient financial responsibility.
Collect payments and facilitate resolution of billing questions.
Establish payment arrangements and evaluate past account history.
Communicate with patients and act as an information resource for other departments and physician offices.
Use CPT and ICD-9 coding knowledge and understand the relationship between diagnoses and procedures to support compliance with payer requirements.
Adhere to Medicare, Medicaid, and other third-party requirements and applicable legislation concerning medical and financial information, debt collection, and credit reporting.
Use EPIC and abide by the department’s service vision.