Patient Access Representative II - 3pm-11pm

The Hospital Authority of Miller County•Colquitt, GA

20h•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 is required.
Minimum of six (6) years medical office experience required.
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 required.
Completion of medical medical terminology course required.
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
Follows Code of Conduct policy.
Adheres to dress code; appearance is neat and clean.
Completes annual educational requirements.
Maintains regulatory requirements.
Always maintain patient confidentiality.
Reports to work on time and as scheduled; completes work within designated time.
Wears identification when on duty; use computerized time clock system correctly.
Completes in-services and returns in a timely fashion.
Attends annual review and/or skills fair and department in-services, as scheduled.
Attempts to end conversations and other interactions in a positive manner leave others with a good impression of the Hospital Authority of Miller County and its employees.
Complies with all organizational policies regarding ethical business practices.
Communicates the mission statement of the organization.
Always treat others in a friendly, helpful manner.
Refers co-workers to proper sources when unable to provide an answer.
Interact with others in a professional and friendly manner.
Takes interest in others and always gives full cooperation to fellow workers.
Always maintains an open line of communication with other departments.
Thoroughly familiar with the hospital and the services it offers.
It is the responsibility of every employee of HAMC to comply with federal, state, and local laws and regulations, as well as HAMC Policies and Procedures.
Every employee is held accountable to participate in, comply with and report concerns to his or her supervisor or the Compliance Officer if illegal or unethical behavior is suspected.
As an employee of HAMC, you have been granted user access to applicable ePHI systems based on your position. This user or role-based access is intended to give you the minimum necessary access to perform your job function(s) only and should be used only as applicable.

Nice To Haves

Additional languages preferred.

Responsibilities

Responsible for obtaining necessary demographic and financial data through patient interviews, the centralized scheduling system and system queries to complete the pre-registration process.
Assures all check-in procedures are completed, and monitors patient wait times, communicating changes to the patient, as necessary.
Reads and interprets insurance responses.
Communicates financial obligations to patients and collects fees at time of service as appropriate.
Accurately performs medical record maintenance and releases.
Performs cash posting following department guidelines.
Abides by organizational and HIPAA guidelines, privacy practices, patient confidentiality and patient rights.
Must maintain high regard for confidentiality.
Notifies patient or guarantor of anticipated financial responsibility including copays, deductibles, or coinsurances and collects accordingly.
Performs cash posting following department guidelines.
Communicates the purpose of and completes all necessary regulatory forms with patient.
Completes patient's visit by scheduling any necessary follow-up appointments to include any specialty or ancillary services as possible.
Documents financial arrangements.
Assist with departmental workflow as needed.
Communicates with Physician Offices, Staff, and other departments.
Familiar with Advance Beneficiary Notice, Medicare Secondary Questionnaire, Medicare Outpatient Observation Notice, Important Message from Medicare, precertification, ICD-10 coding, Medical Terminology.
Identifies patients who require early financial counseling intervention.
Maintains knowledge of departmental applications i.e., CERNER, Relias, Heartland, Hometown Health, GAMMIS, Availity, my ABILITY, and other systems utilized by Patient Access Services.
Adherent to Strict EMTALA guidelines in financial data collection and collection of co-pays are followed.
Strong teamwork between the clinical staff and the financial staff is required.
Strong teamwork, communication and customer service skills are required.
Handles a high volume of incoming calls.
Responds to questions and concerns and directs them to an appropriate location or department.
Responsible for reviewing hospital outpatient service orders for accuracy and medical necessity when required.
Performs all other duties and projects assigned.
Presents consent forms and notifications to patients and obtains all necessary patient signatures and information at time of arrival.
May initiate and perform administrative duties to ensure efficient daily business operations, including participating in the 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.
Auditing Responsibilities: Insurance Verification and Accuracy: Review and verify insurance information for all Inpatient and Swing Bed admissions to ensure accurate and up- to-date coverage is documented.
Required Documentation Compliance: 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.
Primary Care Provider Accuracy: Audit patient records to ensure that the Primary Care Physician (PCP) listed is accurate and updated in the system.
Medicare Secondary Payer(MSP) Questionnaires: Ensure that MSP questionnaires are completed and accurate, with appropriate documentation and any necessary follow- up completed in a timely manner
Medicare and Medicaid Eligibility Checks 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
Portal Consent for Underage Patients 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.
Portal Enrollment Confirmation 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.