Patient Access Representative II - FT - Day - Patient Access Services Pennington NJ

Capital Health (US)•Hopewell, NJ

1d•Onsite

About The Position

Capital Health is seeking a Patient Access Representative II for their Patient Access Services department. This full-time, day shift position is responsible for accurately and efficiently registering patients, maintaining financial integrity of front-end registration and insurance verification, and ensuring customer satisfaction. The role involves applying financial screening guidelines, staying updated on payor and regulatory guidelines, and developing relationships with physician offices to act as a liaison. The position requires proficiency in computer skills, medical terminology, and knowledge of insurance plans.

Requirements

High school diploma or equivalent.
Six months in Patient Access Rep I role at Capital Health or one year customer service experience with medical terminology.
Excellent communication, interpersonal and organizational skills.
Ability to problem solve and multitask and manage frequent interruption.
Expert and current knowledge of all aspects of insurance requirements.
Proficient computer skills.
Familiar with medical terminology.

Nice To Haves

A quality of knowledge of insurance plans and insurance experience preferred.

Responsibilities

Registers patients accurately, efficiently, and independently to ensure database integrity.
Maintains financial integrity of all front-end registration and insurance verification functions while upholding the utmost in customer satisfaction.
Applies all financial screening guidelines and maintains up-to-date knowledge and adheres to all payors and regulatory guidelines for medical insurance claims for processing and reimbursement.
Develops and maintains solid relationships with physician offices and functions as a liaison between offices at Capital Health.
Expert in identifying participating CH insurance plans and ability to identify non-participating plans.
Demonstrates service excellence by professionally assisting patients and customers with the utmost respect in a friendly, caring manner.
Proficient in registering patients quickly and accurately, exceeding productive levels of a Patient Access Rep I.
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 the service.
Essential registration forms are scanned into EMR, and chart follow-up is performed.
Performs all job duties independently with minimal supervision.
Follows all payor requirements and identifies needs for referrals and precertification.
Performs verification of benefits on all patient encounters.
Reviews chart for accuracy.
Follows computer system, internet-based insurance applications, and department operational procedures and training guidelines to obtain accurate demographic, diagnosis, authorizations/referrals, and insurance information on each registration.
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 Patient's Rights.
Ascertains and records appropriately the difference between primary care physician, referring physician, and attending physician.
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.
Assists and supports with staff departmental training.
Attends all mandatory department meetings.
Supports and participates in department performance improvement initiatives.
Performs other duties as needed.