Patient Access Representative III - Duarte

City of Hope•Duarte, CA

41d

About The Position

The Patient Access Representative III checks in and checks out patients for medical group physicians and other licensed providers. The role uses independent judgment to coordinate appointments across multiple hospital departments and uses telecommunications and computer information systems to create accounts, verify patient and insurance information, collect co-pays, and schedule or reschedule complex appointments. The representative serves as a flexible resource for system-specific service lines, works across patient-care areas, and supports an extraordinary patient experience and quality standards. Additional duties include facilitating physician-to-patient communication and serving as an information resource. The position registers, preregisters, obtains consents, and schedules appointments across clinics, ancillary areas, and the hospital. It links preregistration records to appointments, coordinates with other functional areas, maintains productivity and accuracy standards, enters demographic and insurance data, completes legal documents, and obtains and scans related documentation. Duties also include cash collection, patient pricing estimates, and ETC admission. The representative reviews account documentation to ensure financial protocols are met, verifies insurance eligibility, confirms authorizations, and escalates accounts that are not financially secure. The role provides patient itineraries, advance beneficiary notices, and written instructions when applicable; works with Financial Counselors to resolve financial issues and obtain financial clearance; explains the Financial Assistance policy and application process; and provides applications to uninsured patients. It screens ordered tests and communicates tests or diagnoses that may not meet Medicare coverage criteria to physicians or the ABN Specialist. The representative ensures the correct preregistration visit encounter type is linked to appointments, requests service authorizations when applicable, and sends diagnostic test orders to the appropriate department with documentation of the service date and visit number. The role also provides patient-facing customer service, coordinates with colleagues and departments to resolve issues affecting patient care, maintains knowledge of departmental policies and procedures, and performs other assigned departmental duties such as phone calls, fax management, filing, supply inventory, and data entry.

Requirements

High school diploma or equivalent.
Two years of related experience registering and scheduling complex patient appointments in a clinic or hospital setting.
Medical terminology experience.

Responsibilities

Check in and check out patients for medical group physicians and other licensed providers.
Register and preregister patients, obtain consents, and schedule appointments across clinics, ancillary areas, and the hospital.
Create preregistration records and link them to scheduled appointments and the correct visit encounter type.
Coordinate appointments with other functional areas and schedule or reschedule complex appointments.
Accurately enter patient demographic and insurance information; complete legal documents and obtain and scan related documents.
Collect cash and co-pays, provide patient pricing estimates, and perform ETC admission.
Review account documentation, verify insurance eligibility, confirm authorizations, and escalate financially unsecure accounts to management.
Provide itineraries, advance beneficiary notices, and written instructions for tests and procedures as applicable.
Seek assistance from Financial Counselors to resolve financial issues and ensure financial clearance while maintaining patient flow.
Explain the Financial Assistance policy and application process and provide applications to uninsured patients.
Screen ordered tests and communicate tests or diagnoses that may not meet Medicare coverage criteria to physicians or the ABN Specialist.
Request service authorizations when applicable and send diagnostic test orders with service-date and visit-number documentation to the appropriate department.
Greet and assist patients and visitors, serve as a liaison between patients and support staff, and provide physician-to-patient communication and information support.
Communicate effectively with colleagues, physicians, providers, leaders, and other employees across the organization.
Manage changing priorities, respond professionally to difficult situations, recognize high-priority situations, and take appropriate action.
Coordinate with service delivery and other departments to resolve issues affecting patient care and escalate unresolved issues according to departmental guidelines.
Maintain department productivity, accuracy, quality assurance, and service standards, and maintain knowledge of department policies, procedures, and standard work.
Perform other assigned duties, including calls, fax management, document organization and filing, supply inventory, and data entry.