Patient Access Representative III - Business Office

ECU Health Medical Center•Greenville, NC

3d•$17 - $25

About The Position

Responsible for creating the first impression of ECU Health's services for patients, families, and other external customers. The role performs pre-arrival pre-registration and financial clearance for outpatient and inpatient services, collecting accurate demographic, financial, and clinical information and helping ensure hospital bills are paid by a third-party payer or the patient. It also verifies insurance eligibility, coordinates referrals, and secures authorizations. The representative serves as a primary liaison for patients receiving professional and hospital services at ECU Health. This role also provides coaching and focused training to staff, supports departmental workflow and reporting, and serves in a lead capacity for departmental goals and initiatives. The position is full-time, Monday through Friday, with a schedule of either 8:00 AM–5:00 PM or 8:30 AM–5:30 PM.

Requirements

High school diploma or GED or higher.
Two to four years of registration, scheduling, and insurance authorization experience in a healthcare setting.
Five years of customer service experience.
Excellent written and verbal communication, attention to detail, organization, and multitasking skills.
Proficient computer skills, including Microsoft Outlook, Word, and Excel.

Nice To Haves

Associate degree preferred.
Bachelor’s degree preferred.
Experience with EPIC and medical office workflows.
Insurance verification experience.
Surgical scheduling experience.
Knowledge of medical terminology.
Experience with CPT coding.

Responsibilities

Conduct phone interviews and complete pre-certification and insurance verification before patients’ scheduled arrivals.
Collect and enter complete, accurate demographic, financial, and clinical information into the electronic health record for hospital registration.
Obtain diagnosis and procedure information from patients, clinical departments, or physician offices to perform ABN/Medical Necessity screening as required.
Review registration accounts for accuracy to help ensure proper hospital reimbursement.
Work with physician office staff and utilization review/case management to coordinate initial and extended-stay authorizations.
Resolve insurance verification and financial clearance issues before or during hospital services, including contacting insurers or third-party payers about eligibility and benefits and initiating appeals when necessary.
Pre-register patients by transcribing information provided by physicians’ offices.
Explain financial obligations; negotiate deposits and payment arrangements with patients or guarantors; and attempt to collect copayments or other uninsured balances.
Verify insurance benefits using the electronic eligibility application (Passport), internet applications, or telephone calls; obtain authorizations and pre-certifications for applicable visits.
Cross-train to perform other divisional functions as assigned.
Coach new staff as assigned and provide focused training to individuals identified by the Team Lead and/or Supervisor.
Provide management with feedback about issues affecting departmental workflow.
Ensure scheduling and registration reports and work queues are addressed by Insurance Verifiers.
Assist management with special projects and reports.
Serve in a lead capacity for departmental goals and initiatives.
Perform other duties as assigned.