Patient Access Representative II - 3pm-11pm

The Hospital Authority of Miller County•Colquitt, GA

19h•Onsite

About The Position

The Patient Access Services Representative II is responsible for independently managing patient registration, insurance verification, and customer service functions. The representative at this level is expected to have a thorough understanding of patient access workflows and manage more complex situations. In addition to performing all outpatient and inpatient registration functions including hospital cashiering and insurance verification. Ensures that patients meet financial requirements. Provides general information to hospital users, patients, and families. Communicates effectively to service delivery areas to maximize patient flow and customer service. Provides excellent patient focused customer service.

Requirements

Associate degree from an accredited college or University.
Minimum of six (6) years medical office experience.
Complete the competency check List at 30 days, 3-month and 6-month intervals, with the expectation of demonstrating mastery of job skill outlined for each area. (ER, MCMC, MDC, Rehab)
Previous experience with health insurance and patient billing.
Completion of medical terminology course.
Ability to train, mentor, and support junior staff.
Proficient in registration process and electronic health records (EHR) at Hospital Authority of Miller County.
Ability to communicate in English, both verbally and in writing.
Strong written and verbal skills.
Basic Computer Skills.

Nice To Haves

Additional languages preferred.

Responsibilities

Independently manage patient registration, insurance verification, and customer service functions.
Manage complex situations related to patient access workflows.
Perform all outpatient and inpatient registration functions, including hospital cashiering and insurance verification.
Ensure that patients meet financial requirements.
Provide general information to hospital users, patients, and families.
Communicate effectively to service delivery areas to maximize patient flow and customer service.
Provide excellent patient focused customer service.
Perform all job responsibilities in alignment with the mission and vision of the organization.
Perform other duties as required and complete all job functions as per departmental policies and procedures.
Maintain current knowledge in present areas of responsibility (i.e., self-education, attends ongoing educational programs).
Attend staff meetings and complete mandatory in-services and requirements and competency evaluations on time.
Wear protective clothing and equipment as appropriate.
Obtain necessary demographic and financial data through patient interviews, the centralized scheduling system and system queries to complete the pre-registration process.
Assure all check-in procedures are completed, and monitor patient wait times, communicating changes to the patient, as necessary.
Read and interpret insurance responses.
Communicate financial obligations to patients and collect fees at time of service as appropriate.
Accurately perform medical record maintenance and releases.
Perform cash posting following department guidelines.
Abide by organizational and HIPAA guidelines, privacy practices, patient confidentiality and patient rights.
Maintain high regard for confidentiality.
Notify patient or guarantor of anticipated financial responsibility including copays, deductibles, or coinsurances and collect accordingly.
Communicate the purpose of and complete all necessary regulatory forms with patient.
Complete patient's visit by scheduling any necessary follow-up appointments to include any specialty or ancillary services as possible.
Document financial arrangements.
Assist with departmental workflow as needed.
Communicate with Physician Offices, Staff, and other departments.
Demonstrate familiarity with Advance Beneficiary Notice, Medicare Secondary Questionnaire, Medicare Outpatient Observation Notice, Important Message from Medicare, precertification, ICD-10 coding, and Medical Terminology.
Identify patients who require early financial counseling intervention.
Maintain knowledge of departmental applications i.e., CERNER, Relias, Heartland, Hometown Health, GAMMIS, Availity, my ABILITY, and other systems utilized by Patient Access Services.
Handle multiple tasks and responsibilities with attention to detail.
Perform efficiently and effectively under stress.
Adhere to Strict EMTALA guidelines in financial data collection and collection of co-pays.
Exhibit strong teamwork, communication and customer service skills.
Handle a high volume of incoming calls.
Respond to questions and concerns and direct them to an appropriate location or department.
Review hospital outpatient service orders for accuracy and medical necessity when required.
Present consent forms and notifications to patients and obtain all necessary patient signatures and information at time of arrival.
Initiate and perform administrative duties to ensure efficient daily business operations, including participating in office/department opening and closing procedures, assisting with maintaining, ordering, and restocking front office supplies, and receiving and distributing mail.
Assist Supervisor and/or Manager with development of staff by being available to teammates, acting as a resource to help complete complicated/complex tasks, providing on the job training to team, and seeking out opportunities to become actively involved in staff workflow and development.
Perform regular audits and quality checks to ensure accuracy, compliance, and optimal patient experience.
Review and verify insurance information for all Inpatient and Swing Bed admissions to ensure accurate and up-to-date coverage is documented.
Confirm that all required patient forms, including but not limited to the MOON (Medicare Outpatient Observation Notice) form, have been properly signed by the patient or their guarantor.
Audit patient records to ensure that the Primary Care Physician (PCP) listed is accurate and updated in the system.
Ensure that MSP questionnaires are completed and accurate, with appropriate documentation and any necessary follow-up completed in a timely manner.
For all patients listed with Medicare or Medicaid, verify eligibility and confirm there are no active Medicare Advantage or Medicaid CMO (Care Management Organization) plans that would alter billing or coverage.
Audit portal consents for patients under age 18 to ensure proper authorization and that access limitations for minors are observed in accordance with privacy regulations.
Review patient portal consent forms to ensure patients who opted to sign up were successfully sent an invitation and access link.
Investigate and resolve any issues preventing access.
Follow Code of Conduct policy.
Adhere to dress code; appearance is neat and clean.
Complete annual educational requirements.
Maintain regulatory requirements.
Maintain patient confidentiality.
Report to work on time and as scheduled; complete work within designated time.
Wear identification when on duty; use computerized time clock system correctly.
Complete in-services and return in a timely fashion.
Attend annual review and/or skills fair and department in-services, as scheduled.
Attempt to end conversations and other interactions in a positive manner, leaving others with a good impression of the Hospital Authority of Miller County and its employees.
Comply with all organizational policies regarding ethical business practices.
Communicate the mission statement of the organization.
Treat others in a friendly, helpful manner.
Refer co-workers to proper sources when unable to provide an answer.
Interact with others in a professional and friendly manner.
Take interest in others and always give full cooperation to fellow workers.
Maintain an open line of communication with other departments.
Be thoroughly familiar with the hospital and the services it offers.
Comply with federal, state, and local laws and regulations, as well as HAMC Policies and Procedures.
Participate in, comply with and report concerns to his or her supervisor or the Compliance Officer if illegal or unethical behavior is suspected.
Use user access to applicable ePHI systems based on your position, ensuring minimum necessary access to perform your job function(s) only.