Patient Access Representative IV - FT - Day - Patient Access Services Pennington NJ

Capital Health (US)•Hopewell, NJ

1d•Onsite

About The Position

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region. Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates. The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Requirements

High school diploma or equivalency.
Two-year patient access experience.
Knowledge of all Capital Health departments required.
Proficient computer skills.
Advanced health insurance and prior authorizations knowledge.
Possesses ability to work independently and as a team member.

Nice To Haves

Excellent verbal and written skills.
Strong customer service and problem-solving skills.

Responsibilities

Functions as subject matter expert to ensure department compliance with system and operational changes and assists in training to support ongoing staff education and development.
Able to perform all registration functions independently.
Registers patients accurately, efficiently, and professionally to ensure database integrity and facilitate claims processing.
Applies financial screening guidelines to ensure collectable accounts.
Utilizes standards, guidelines, and written procedures for performing registration functions.
Communicates effectively and works cooperatively with others.
Assists in training, problem solving, and chart review with subordinate patient access representatives.
Assigns duties to registrars as directed by Supervisor or Manager.
Demonstrates ability to independently manage all assigned responsibilities.
Able to troubleshoot any department issues.
Expert in all Patient Access department needs.
Provides coverage in working areas as required when on-call duties apply.
Advanced in registering patients quickly and accurately, exceeding productive levels of a Patient Access Rep III.
Acts as a liaison for physician offices and ancillary departments as needed.
Serves as a resource for Patient Access department.
Leads department through daily workload and divides work as needed.
Follows compliance with computer system procedures, department procedures, and training guidelines to accurately complete each registration.
Reviews charts for accurate demographics, Medicare compliance, proper CPT codes, authorizations and referrals, necessary signatures, and completion of all forms.
Performs follow up with physician office, central scheduling and insurance companies to obtain any required authorization, referrals or to obtain update physician orders.
Complies with department procedures and regulatory guidelines for Medicare Secondary Payer, Medicare Medical Necessity, Advance Beneficiary Notice, Advance Directives, Patients’ Rights, and the Interpreter flag as measured by review and observation.
Follows and monitors staff compliance with following payer requirements for authorization, pre-authorization, referrals, coordination of benefits, and in-network verification according to Insurance Database, and Insurance Verification guidelines.
Follows Self Pay procedure regarding No Surprise Billing Act and referrals to Medicaid and charity.
Assists with departmental training and education of patient access staff.
Communicates effectively with Patient Access team members and is open to feedback and suggestions in order to identify opportunities for improvement.
Identifies and seeks out members of the registration department as a resource to increase knowledge and seek validation of department guidelines and procedures.
Reports to Management Team regarding department deficiencies to include faulty equipment, supplies and concerns.
Supports department performance improvement initiatives.
Communicates ideas to meet department goals.
Attends all mandatory department meetings.
Follows patient identification policy.
Performs other duties as needed.