Patient Access Representative II

Ellis Medicine•Schenectady, NY

About The Position

The Patient Access Representative II verifies patient demographic and financial information and prepares accounts for billing upon discharge. The role interacts with third-party payers to verify insurance benefits, interviews patients to confirm admission information and explain financial responsibilities, enters data to prepare accounts for billing, identifies payment sources for uninsured patients, and performs cashier duties. The position also coordinates patient appointments and patient flow for pre-admission testing and other departments. It requires maintaining patient confidentiality, following privacy policies and procedures, completing required training, and performing other duties as assigned.

Requirements

High school diploma or equivalent required.
Five years of patient registration, business office, or billing experience in a healthcare setting preferred.

Nice To Haves

Associate’s degree preferred.
Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) certification preferred.

Responsibilities

Verify patient demographic and financial information and prepare accounts for billing upon discharge.
Provide patient information to physician offices when requested.
Verify insurance eligibility, benefits, precertification, and coverage through applicable payer systems and contact employers, workers’ compensation, commercial, and no-fault carriers as needed.
Visit in-house patients to gather missing demographic, financial, and insurance information.
Explain financial obligations to patients, including copayments, deductibles, and other liabilities, and make appropriate financial arrangements.
Secure signed payment agreements and assist uninsured patients with payment sources and financial obligations.
Provide Medicaid applications and required-document lists to eligible patients, complete the application process, and submit applications to the County Department of Social Services.
Screen eligibility and assist patients with the Charity Care program.
Complete and send monthly bills to applicable in-house alternative-level-of-care patients and patients without a payment source.
Prepare cashier documentation for discharged patients, including information to obtain and payments to collect.
Input and update demographic and financial information in the ACTION system and prepare inpatient accounts for billing.
Review the in-house census daily to confirm insurance plans and allocations are set up appropriately.
Complete a financial contact sheet for each patient and document special billing and payment instructions.
Pull discharged accounts daily and forward them to the Business Office.
Facilitate collection of accurate patient billing information and collect outstanding patient accounts receivable.
Estimate patient liability, including copayments, deductibles, coinsurance, and deposits, using accurate demographic and financial information.
Receive and process patient payments, maintain necessary petty cash, and answer questions about patient liability and its contributing factors.
Receipt and forward patient payment receipts and post payments to patient accounts in Soarian Financials.
Perform end-of-day closing and reconciliation duties in Soarian Financials and reconcile deposit slips.
Schedule and coordinate patient appointments in advance according to guidelines for pre-admission testing and other departments, based on physician orders and individual patient needs.
Communicate with patients and the Pre-Admission Testing Center to facilitate patient flow and avoid delays.
Verify that required tests have been completed within acceptable time frames and obtain test reports instead of repeating tests when possible.
Prepare and distribute daily pre-admission testing schedules to the PAT Center, ancillary departments, and Patient Registration Office one day before appointments.
Coordinate pre-admission testing for heart catheterization patients with the Cardiac Catheterization Lab and coordinate pre-procedure teaching with cardiac staff.
Use available appointment time blocks to optimize services without overbooking.
Coordinate certain Gastroenterology Unit procedures with the Radiology Department schedule.
Prepare daily Operating Room, Delivery Room, Gastroenterology Unit, and Eye Clinic schedules and deliver copies to appropriate ancillary departments.
Assist with patient flow and access to services when necessary.
Complete required training and adhere to patient privacy policies and procedures while maintaining confidentiality.
Perform other duties as assigned.