Patient Access Representative III

Conifer Health Solutions•Delray Beach, FL

2d•Onsite

About The Position

The Patient Access Representative III supports departmental efficiency by performing patient registration, pre-admission and admission, reception, and discharge functions; arranging requested hospital support services through referrals; analyzing admission, discharge, and transfer (ADT) information and Revenue Cycle Reports; leading shift Patient Access Operations; and collaborating with department leaders on process and operational excellence. The role is based at Delray Medical Center and is scheduled Monday through Friday, 8:30 a.m. to 5:00 p.m., with rotating weekend work. The employee must also be available to work hours and days as needed based on departmental or system demands. Responsibilities include greeting patients and providing customer service, completing registrations, handling and explaining required legal forms, scanning protected health information, preparing patient information packets, and potentially assisting with procedure scheduling and patient or physician-office interviews. The representative provides financial counseling and education, makes referrals, collects patient liabilities using compliant techniques, and reconciles and enters payments. The role also verifies medical necessity, insurance, benefits, coverage, and eligibility; completes financial-clearance worklists; obtains authorizations; and notifies payors of inpatient visits. The position requires work in a hospital administration setting and may involve patient-care locations with potential exposure to life-threatening patient conditions, extreme patient volumes, and uncooperative patients. Candidates must meet applicable vaccination and screening requirements before starting employment.

Requirements

High school diploma or GED required.
2–4 years of experience in a medical facility, health insurance, or a related area.
Minimum typing speed of 35 words per minute.
Working knowledge of software, systems, equipment, and PCs.
Advanced customer service skills and experience.
Ability to work in a fast-paced environment.
Ability to receive and communicate detailed information orally and in writing.
Advanced patient-liability collection performance and high productivity achievement.
Ability to perform essential job duties in at least three Patient Access service areas, including the Emergency Department.
Ability to sit at a computer terminal for extended periods, occasionally lift or carry up to 25 pounds, and frequently stand, sit, and walk for prolonged periods.
Must be able to occasionally push a wheelchair to assist patients with mobility problems.
Must obtain and provide confirmation of required vaccinations and screenings before starting employment, as applicable and permitted by law.
Must be available to work hours and days as needed based on departmental or system demands.

Nice To Haves

At least 2 years of experience in Patient Access.
Some college coursework.
Knowledge of functions and relationships within a hospital environment.
Advanced understanding of third-party payor requirements.
Advanced understanding of compliance standards.

Responsibilities

Greet patients and provide customer service in accordance with Conifer Standards of Care.
Complete patient registration at the date of service and follow financial and cash-control policies and procedures.
Explain and secure required hospital and patient legal forms, including Advance Directives, Conditions of Services, Consent for Treatment, Important Message from Medicare, and EMTALA forms.
Scan protected health information and create and file patient information packets or folders for upcoming hospital services.
Assist, as needed, with scheduling diagnostic or surgical procedures, conducting physician-office or patient interviews, and explaining hospital procedure guidelines and policies.
Provide patient financial counseling, education, and referrals.
Complete patient-liability collection escalations using proper, compliant collection techniques before, during, and after the date of service.
Perform hospital cash reconciliation and secure payment entry in accordance with financial and cash-control policies and procedures.
Verify medical necessity in accordance with applicable Centers for Medicare & Medicaid Services requirements, and verify insurance, benefits, coverage, and eligibility.
Complete assigned registration financial-clearance worklist activities, obtain insurance authorizations for scheduled and unscheduled hospital services, and secure inpatient visit notification to payors.
Analyze admission, discharge, and transfer information and Revenue Cycle Reports.
Lead shift Patient Access Operations and collaborate with department leaders on process and operational excellence.
Use professional negotiation techniques to collect money owed by patients or guarantors.
Build and maintain collaborative relationships with internal and external clients to improve communication, productivity, and accuracy.
Resolve physician-office and patient issues.