Patient Access Representative - PRN

Trinity Health•Athens, GA

About The Position

This part-time, PRN position requires open availability during the week and on weekends. The Patient Access Representative provides patient-focused customer service and performs outpatient and/or inpatient registration and insurance verification. The role collects patient financial liability payments and ensures patients meet financial requirements, including Medicare medical necessity, payer pre-certifications, and referrals. It also provides general information to hospital users, patients, families, and physician offices. No benefits are aligned with this position. The role supports operational and performance-improvement work by researching, collecting, and analyzing information; preparing and distributing analytical reports; and collaborating on improvements related to program efficiency and patient experience. It uses multiple system applications to conduct analysis, create reports, and develop educational materials, while applying knowledge of organizational processes and prioritizing quality, confidentiality, and safety. Depending on the functional role level, responsibilities may include cross-training in Pre-Service, the Emergency Department, or Bed Desk; explaining insurance benefits; and using specialized knowledge and analysis to support organizational objectives. The Patient Access Account Specialist function may also involve analyzing, processing, and editing items for correctness under payer guidelines, resolving items to ensure accurate billing, and processing payments promptly. The position requires a high school diploma or equivalent. HFMA CRCR or NAHAM CHAA certification is required within one year of hire. Experience requirements vary by functional role level: PAR I requires at least one year of customer service experience; PAR II requires at least two years of hospital registration or insurance verification experience; and Patient Access Account Specialist requires more than two years of hospital registration or insurance verification experience.

Requirements

High school diploma or equivalent.
HFMA CRCR or NAHAM CHAA certification required within one year of hire.
PAR I: At least one year of customer service experience.
PAR II: At least two years of hospital registration or insurance verification experience upon hire.
PAR II: Knowledge of medical terminology, diagnostic coding, and procedural coding; ability to explain insurance benefits.
Patient Access Account Specialist: More than two years of hospital registration or insurance verification experience.
Availability during the week and on weekends.

Nice To Haves

Patient Access experience is preferred for PAR I.
Medical terminology and knowledge of diagnostic and procedural coding.
Insurance verification experience, ability to explain benefits, and ability to secure necessary authorization.

Responsibilities

Provide patient-focused customer service.
Perform outpatient and/or inpatient registration and insurance verification.
Collect patient financial liability payments.
Ensure patients meet financial requirements, including Medicare medical necessity, payer pre-certifications, and referrals.
Provide general information to hospital users, patients, families, and physician offices.
Research, collect, and analyze information; identify opportunities; develop solutions; and lead issues through resolution.
Collaborate on performance-improvement activities related to program efficiency and patient experience.
Prepare and distribute analytical reports.
Use system applications to perform analysis, create reports, and develop educational materials.
Research and compile information for ad hoc operational projects and initiatives.
Synthesize and analyze data, prepare detailed summaries and graphical presentations showing trends, and recommend practical options or solutions.
Use program and operational data and measurements to define and demonstrate progress, return on investment, and impacts.
For applicable role levels, cross-train and perform activities in Pre-Service, the Emergency Department, and/or Bed Desk.
For applicable specialist functions, analyze, process, and edit items for correctness based on payer guidelines; resolve items to ensure claims are billed accurately; and process payments timely.
Follow applicable laws, regulations, organizational policies, procedures, and guidelines, maintaining ethical and professional behavior and safe work practices.