Patient Access Representative II

Emory•Atlanta, GA

About The Position

The Patient Access Representative II coordinates, prioritizes, and completes front-end patient registration activities from pre-registration through discharge. The role verifies insurance and ensures requirements are met, completes accurate registrations according to departmental standards and applicable regulations, and prioritizes work to support reimbursement and reduce financial risk to patients and the hospital. The representative communicates financial policies and patient liability, collects amounts due when appropriate, and identifies patients who may need financial counseling. The position also assists patients, guarantors, and families with insurance questions and escalates unresolved benefit concerns to a Financial Counselor. This role requires a self-motivated person who can manage time effectively in a fast-paced, high-volume environment. The representative maintains knowledge of insurance, registration, scheduling, referrals, authorizations, account follow-up, and Patient Access system applications. The position requires compliance with state and federal regulations and professional handling of confidential information. Physical requirements include lifting and carrying objects up to 25 pounds, standing and walking occasionally to frequently, sitting occasionally, and performing close eye work such as computer use, typing, reading, and writing. Environmental exposures and conditions vary by assigned work area and tasks and may include blood-borne pathogens, biohazardous waste, chemicals or fumes, communicable diseases, electrical shock, varied floor surfaces and temperatures, indoor or outdoor conditions, latex, patient-care or handling injuries, and radiation. Personal protective equipment, including respirators, may be used. Shift work and travel may be required.

Requirements

High school diploma or equivalent.
At least 2 years of healthcare-related or customer service experience; an associate or bachelor's degree may be accepted in lieu of experience.
Typing speed of at least 35 words per minute.
Good communication skills.
Ability to manage time, handle high patient volumes, and work in a fast-paced environment.
Ability to maintain knowledge of insurance, registration, scheduling, referrals, authorizations, account follow-up, and multiple Patient Access system applications.
Ability to maintain confidentiality and follow applicable policies, procedures, and regulations.

Nice To Haves

Knowledge of Medicare, Medicaid, and other commercial payers, including HMO and PPO plans.
Certified Healthcare Access Associate (CHAA) certification.

Responsibilities

Coordinate, prioritize, and complete patient registration activities from pre-registration through discharge.
Verify patient insurance and ensure insurance requirements are met before or on the date of service.
Complete accurate registrations according to departmental protocols, standards, policies, procedures, and regulatory requirements.
Call patients to pre-register or confirm appointments.
Prioritize work to support optimal reimbursement and reduce financial risk to the patient and hospital.
Inform patients of their financial liability and make every appropriate attempt to collect it; document when payment is not collected.
Identify patients who need early financial counseling and refer uninsured patients to a financial counselor as appropriate.
Assist patients, guarantors, and families with insurance questions and escalate unresolved benefit concerns to the department Financial Counselor.
Maintain confidentiality of patient, employee, and other protected information.
Search the database to determine whether a patient is new or established.
Obtain required signatures for release of information and registration documents, and scan appropriate documents, patient identification, and insurance cards.
Verify information and insurance for established patients or enter information for new patients before discharge; reconfirm date of birth and legal spelling of the patient's name.
Distribute registration paperwork according to departmental procedures.
Schedule procedures and follow-up appointments.
Communicate hospital financial policies to patients.
Maintain the department's monthly accuracy rate and established productivity, quality, and collections standards.
Respond appropriately and promptly to verbal and written requests; communicate issues and concerns professionally and contribute ideas for improvements.
Perform duties in support of the EHC Patient Access Mission Statement and comply with applicable regulations and guidelines, including EMTALA, CMS, HIPAA, and JCAHO.