Patient Access Representative III

University of Maryland Medical System•Glen Burnie, MD

2d•$20 - $29

About The Position

Coordinates and performs scheduling, registration, pre-admission processing, wayfinding, and other administrative duties in accordance with department-specific standards for data entry and patient selection. In addition to the responsibilities of the Facilities Admissions Coordinator II role, this position includes verification of insurance benefit eligibility, insurance pre-certification and authorization, and the creation and/or finalization of cost estimates. Serves as back-up support to the Supervisor as assigned. The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job responsibilities performed. Works with care teams and the revenue cycle to identify and eliminate barriers to access, reimbursement, and affordable care. Provides education to patients and families regarding the financial clearance process and offers information related to estimated costs of services and available financial assistance opportunities. Performs specific administrative and Admission, Discharge, and Transfer (ADT) functions and carries out these duties across multiple clinics and registration areas within the institution. Facilitates at-the-elbow departmental training for new and existing employees. Serves as a subject matter expert for the team and independently resolves less complex issues. Manages assigned projects independently. Serves as the first point of contact for patients and visitors who enter the facilities and is responsible for all aspects of customer service within Patient Access/Patient Administrative Services areas in a manner that ensures a customer-focused, quality-conscious work climate, recognizing that patient visits are often filled with anxiety and uncertainty. Functions include applying strong interpersonal skills, data collection, the ability to assess situations, and leading the team in developing solutions to achieve excellence in customer service while ensuring the financial viability of the hospital. Collects and verifies patient and insurance demographics; verifies insurance benefits and coverage by reviewing benefits information in Epic; provides cost estimates; secures pre-certifications and/or pre-notifications for patient services; collects co-pays and deposits prior to services; and provides financial assistance information to patients. Provides wayfinding to all clinics for which Patient Administrative Services provides registration assistance. Staff must be knowledgeable of clinic locations to safely and efficiently guide patients to their appointments. Maintains regulatory and functional knowledge of all required registration information to ensure timely and accurate reporting and billing; obtains all required signatures; and performs clerical duties as necessary. Educates patients regarding adequate insurance coverage. Understands applicable hospital and physician billing requirements and communicates proper procedures and requirements to patients. Communicates coverage issues to service areas and works with patients and staff to resolve them. Escalates issues to management when necessary. Ensures accuracy and completion of paperwork prior to filing admissions. Contacts physician and clinical staff to resolve incomplete patient registration documentation and distributes admission documents as required. Ensures department scheduling templates are maintained for applicable providers in outpatient department locations and supports appropriate scheduling utilization. Maintains consistent contact with the Care Management and Social Work departments to ensure required information has been obtained for reimbursement and that pre-admission and pre-certification requirements are followed. May be required to be on call at specific UMMS facilities. Must be willing to travel between facilities as needed, as applicable to specific UMMS facilities. Perform all other duties as assigned.

Requirements

High school diploma or GED.
Three (3) years of work experience in a clerical, customer service, or receptionist position.

Nice To Haves

Certification and membership in local or national professional organizations such as AAHAM, NAHAM, etc., are preferred.
Five (5) years of work experience in a clerical, customer service, or receptionist position.
Previous experience in a healthcare setting.

Responsibilities

Coordinates and performs scheduling, registration, pre-admission processing, wayfinding, and other administrative duties.
Verifies insurance benefit eligibility, insurance pre-certification and authorization.
Creates and/or finalizes cost estimates.
Serves as back-up support to the Supervisor as assigned.
Works with care teams and the revenue cycle to identify and eliminate barriers to access, reimbursement, and affordable care.
Provides education to patients and families regarding the financial clearance process and offers information related to estimated costs of services and available financial assistance opportunities.
Performs specific administrative and Admission, Discharge, and Transfer (ADT) functions across multiple clinics and registration areas.
Facilitates at-the-elbow departmental training for new and existing employees.
Serves as a subject matter expert for the team and independently resolves less complex issues.
Manages assigned projects independently.
Serves as the first point of contact for patients and visitors, responsible for all aspects of customer service within Patient Access/Patient Administrative Services areas.
Applies strong interpersonal skills, data collection, and the ability to assess situations.
Leads the team in developing solutions to achieve excellence in customer service while ensuring the financial viability of the hospital.
Collects and verifies patient and insurance demographics.
Verifies insurance benefits and coverage by reviewing benefits information in Epic.
Provides cost estimates.
Secures pre-certifications and/or pre-notifications for patient services.
Collects co-pays and deposits prior to services.
Provides financial assistance information to patients.
Provides wayfinding to all clinics for which Patient Administrative Services provides registration assistance.
Maintains regulatory and functional knowledge of all required registration information to ensure timely and accurate reporting and billing.
Obtains all required signatures.
Performs clerical duties as necessary.
Educates patients regarding adequate insurance coverage.
Understands applicable hospital and physician billing requirements and communicates proper procedures and requirements to patients.
Communicates coverage issues to service areas and works with patients and staff to resolve them.
Escalates issues to management when necessary.
Ensures accuracy and completion of paperwork prior to filing admissions.
Contacts physician and clinical staff to resolve incomplete patient registration documentation and distributes admission documents as required.
Ensures department scheduling templates are maintained for applicable providers in outpatient department locations and supports appropriate scheduling utilization.
Maintains consistent contact with the Care Management and Social Work departments to ensure required information has been obtained for reimbursement and that pre-admission and pre-certification requirements are followed.
May be required to be on call at specific UMMS facilities.
Willing to travel between facilities as needed.
Perform all other duties as assigned.