Patient Access Representative I

Medical University of South Carolina • Charleston, SC

19h • Onsite

About The Position

The Patient Access Representative exhibits a high level of customer service while verifying and preparing all patient accounts for inpatient and outpatient billing in order to maximize payment for Hospital and Clinic services. This role involves reviewing and verifying all payment methods available (insurance, self-pay, agency), verifying patient/insurance information, working with patients to set up payment arrangements and to arrange/apply for assistance programs, assisting in collecting copayments and deductibles, and problem-solving basic billing inquiries. The position reports to the Patient Access Manager.

Requirements

• Excellent customer service skills
• Ability to receive and express detailed information through oral and written communications
• Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors
• Knowledge of insurance plans and benefits
• Computer literate and able to operate in multiple applications such as Microsoft Office
• Minimum typing skills of 35-40 wpm (certified typing test results required)
• Requires eye-hand coordination and manual dexterity
• Requires the use of office equipment, such as computer terminals, telephone, and copiers
• Knowledge of medical terminology
• Able to handle multiple tasks simultaneously
• Ability to work weekends, Friday, Saturday, and Sunday
• Must be flexible and able to work flex and staggered shifts
• Associate Degree or High School Diploma with 2 years of customer service experience
• Ability to interpret and apply financial procedures and regulations preferred
• Previous experience with hospital information systems or word processing preferred

Nice To Haves

• Patient Access Certification

Responsibilities

• Obtains/confirms and enters/updates demographic and insurance information for all patients, including confirming, entering, and/or updating all required demographic data on patient and guarantor in registration system(s) daily.
• Secures and/or explains copies of insurance card(s), forms of ID, and signature(s) on all required forms and scans them into the appropriate imaging documentation system.
• Completes the Medicare Secondary Payer (MSP) questionnaire, if applicable.
• Discusses Advanced Directives with patients and obtains a copy for the patient’s record, if available.
• Reviews all other regulatory forms and information with the patient, such as Notice of Privacy Practice and Billing information.
• Verifies insurance using Real Time Eligibility, Payer Website, or phone number to determine coordination of benefits and obtains authorization and/or referrals as required.
• Follows procedures to accurately identify a patient and apply the patient identification bracelet, if applicable.
• Registers patients during downtime following downtime procedures and enters data into registration system immediately upon system availability.
• Performs Service Recovery as needed at the point of service with patients and visitors.
• Verifies financial information to determine insurance coordination of benefits, pre-certification/prior-authorization requirements by contacting the insurance company or through other verifying technology.
• Informs self-pay patients of prepayment requirements or screens for funding sources.
• Prepares estimate of procedures, calculates advance payment requirements, and informs patient of acceptable payment arrangements on previous and current balances.
• Refers potentially eligible patients to contract eligibility vendor(s) to pursue funding reimbursement.
• Coordinates with clinical areas to establish patient financial expectations and assist in the resolution of revenue cycle issues.
• Maintains up-to-date knowledge, requirements, and skills to perform daily duties and meet key performance metrics for the facility, unit, and payers.
• Collects, posts, and reconciles all payments from patients, including collecting patient payments and providing receipts accurately.
• Calls patient prior to date of service to inform them of their expected financial liability, educating them on their respective benefits and accepting payment over the phone if the patient agrees.
• Coordinates with appropriate providers when payment is unable to be collected from the patient, securing a waiver for services if necessary.
• Accurately posts all payments on the system.
• Accurately reconciles receipts with cash collected and completes required balancing forms at the end of their shift.
• Performs other position-appropriate duties as required in a competent, professional, and courteous manner.

Benefits

• Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees.

What This Job Offers

• Job Type: Part-time
• Career Level: Entry Level
• Education Level: Associate degree
• Number of Employees: 501-1,000 employees