Patient Access Representative

United Surgical Partners International Inc (USPI)•Modesto, CA

4d•$25 - $32

About The Position

Coffee Road Surgery Center is hiring a Patient Access Representative for its fast-paced Ambulatory Surgery Center. The role is responsible for complete and accurate registration of all patients receiving services at the facility, including gathering and entering patient information, verifying benefits for non-pre-registered patients, obtaining required signatures, and collecting patient payments. The representative helps ensure the registration process is efficient, complete, timely, and consistent with the facility’s customer service philosophy.

Requirements

High school graduation or equivalent is required.
Ability to accurately type 40 WPM, complete forms and simple correspondence, handle payment transactions, and enter data.
Excellent verbal and written communication and interpersonal skills.
Ability to manage multiple tasks and short timelines, prioritize and organize work, and complete assignments accurately and on time.
Ability to communicate effectively, tactfully, and diplomatically with patients, families, medical staff, coworkers, employers, and insurance representatives.
Pleasant disposition, positive attitude, and ability to remain cordial and professional during stressful periods.
Basic computer skills and ability to use office equipment including a photocopier, telephone, fax machine, and calculator.
Ability to think and act decisively in a timely manner.
Ability to maintain operational knowledge of insurance requirements needed to achieve optimal reimbursement.

Nice To Haves

Two years of college.
Experience in patient registration, verification, and authorization in a medical center or comparable institution.
Working knowledge of governmental regulations and other reimbursement criteria.

Responsibilities

Communicate with clinical departments or scheduling staff to obtain scheduled appointments and orders before the service date.
Pre-register at least 98% of scheduled patients at least three business days before arrival.
Obtain, validate, and enter patient demographic and insurance information accurately, including information received directly from patients or physician offices by telephone or fax.
Review the MPI to help avoid duplicate medical record numbers.
Obtain signatures on forms and documents required by the hospital or law.
Ensure the MSP Questionnaire is completed for every Medicare registration.
Coordinate with physician office staff, schedulers, and hospital departments to prepare necessary information before patient arrival.
Use online programs to verify insurance eligibility and benefits and document findings on patient accounts.
Assist with contacting insurance companies for pre-authorizations and pre-certifications when requested by the Director.
Communicate with physician office staff to resolve authorization issues and coordinate registrations.
Collect co-payments, deductibles, and co-insurance at the time of service based on prior verification or available insurance information.
When assigned to Emergency registration, ensure compliance with EMTALA regulations.
Log cash collected, generate receipts, and maintain balanced cash at all times.
Meet monthly cash collection goals established with Department Director/Manager and CBO.
Obtain and copy or scan insurance cards and driver licenses.
Use the phone system professionally, handle and transfer incoming calls, and assist with internal calls when requested.
Perform reception and greeter duties at the front desk as needed.
For Community Hospital only, verify medical licensure and check Medicare Sanctions websites for non-credentialed physicians ordering outpatient diagnostic tests.
Provide high-quality customer service and communication to internal and external contacts and help ensure a positive experience for patients and families.
Meet established individual and team quality and productivity standards.
Adapt positively to changes in policies, procedures, operations, and insurance requirements.
Support team-based results and collaborate with colleagues.
Follow time and attendance standards and provide timely notification of absence or tardiness.
Protect patient confidentiality in accordance with HIPAA guidelines.
Demonstrate required job competencies annually through testing, quality reviews, or direct observation.
Track and monitor productivity as requested.
Keep the Department Director or Team Lead informed of registration delays.
Maintain current knowledge of scheduling, registration, insurance verification, and related processes to provide coverage for other team members.
Perform other duties as assigned.