Patient Access Representative II FT Days
About The Position
Under limited supervision, functions as a resource to Patient Access Representative I, providing training and orientation on department methods, procedures, and policies. Assists in establishing departmental policies and procedures. Resolves complex eligibility or insurance verification problems by contacting patients, families, state/government agencies, other hospital departments, and third-party payers. Assists Financial Counselors with financial counseling, helping patients identify and obtain payment sources, and resolving complex or sensitive issues. Participates in bed management, verifies insurance coverage and benefits, obtains authorizations and referrals, and calculates estimated patient liability. Reviews, monitors, and reconciles patient accounts for accurate bill production, ensuring compliance with third-party payer requirements. Registers and schedules patients, explaining forms and ensuring completion of necessary consents and regulatory documents. Obtains accurate insurance, medical, and demographic data for patient admission/pre-admission. Determines and collects patient co-pays/deductibles. Assists uninsured patients with applications and payment arrangements. Coordinates scheduling of tests/services and acts as a liaison between patients and the health facility, answering questions about policies and billing. Completes telephone registrations, resolves bill holds, and reconciles rejected transactions. Assists with special projects and performs duties of a Lead as requested.
Requirements
- High school diploma, associate degree in related area desired.
- Two to three years of progressively more responsible experience in patient access, hospital registration or related area.
- Advanced knowledge of third party payers requirements, reimbursements and copayments/deductible collections etc.
Responsibilities
- Functions as a resource to Patient Access Representative I, providing training and orientation.
- Provides input for establishing departmental policies and procedures.
- Resolves complex eligibility or insurance verification problems.
- Assists Financial Counselor with financial counseling services.
- Participates in bed management.
- Verifies insurance coverage and benefits, obtains authorizations and referrals, and calculates estimated patient liability.
- Reviews, monitors, and reconciles patient accounts to ensure accurate bill production.
- Ensures compliance with third-party payer requirements.
- Registers and schedules patients for health services.
- Explains appropriate forms to patient and family and ensures completion of necessary documents.
- Obtains accurate insurance, medical and demographic data to admit or pre-admit patients.
- Determines patient co-pay/deductibles and collects payment.
- Assists patients without medical insurance coverage in completing medical assistance applications and/or making payment arrangements.
- Coordinates scheduling of all tests and/or services.
- Develops liaison relationship between patient and health facility.
- Assists patients in completing necessary forms and obtains patient signature.
- Collects referrals and authorizations; attempts to secure telephone referral if necessary.
- Completes telephone registrations as appropriate.
- Resolves bill holds in a timely manner.
- Reconciles and corrects any rejected transactions on user specific Transmission, Control and Errors (TCE) reports.
- Assist and participates in special projects as assigned.
- Communicates clinical, financial, and administrative information.
- Performs duties of Lead as requested.
- Performs other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
