Patient Access Representative

USPI•San Antonio, TX

10d

About The Position

USPI Foundation Surgical Hospital is seeking a motivated PRN Patient Access Representative. The facility has 25 beds, eight operating rooms, and three emergency rooms, and performs outpatient orthopedic and spine surgical procedures. The Patient Access Representative is responsible for complete and accurate registration of all patients receiving services at the facility. The role gathers and enters patient information from patients and physician offices, verifies benefits for non-pre-registered patients, obtains required signatures, and collects co-payments, deductibles, and co-insurance at the time of service. The representative supports an efficient, complete, timely registration process consistent with the facility’s customer service philosophy.

Requirements

High school graduate or equivalent required.
Experience in patient registration, verification, and authorization in a medical center or comparable institution.
Ability to type accurately at 40 WPM and complete forms and simple correspondence, handle payment transactions, and enter data.
Excellent verbal and written communication and interpersonal skills.
Ability to handle multiple tasks with short timelines, prioritize and organize work, and complete assignments accurately and on time.
Ability to interact and communicate effectively, tactfully, and diplomatically with patients, families, medical staff, coworkers, employers, and insurance representatives.
Pleasant disposition, positive attitude, and ability to maintain a cordial, professional approach during stressful periods.
Skill using office equipment, including basic computer systems, 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 necessary to achieve optimal reimbursement.

Nice To Haves

Working knowledge of governmental regulations and other reimbursement criteria preferred.

Responsibilities

Coordinate with clinical departments or scheduling representatives to obtain appointments and orders before the service date.
Pre-register 98% of scheduled patients at least three business days before arrival.
Obtain, validate, and accurately enter patient demographic and insurance information, including information received directly, by telephone, or by fax.
Review the MPI to prevent duplicate medical record numbers.
Obtain signatures on forms and documents required by the hospital and by law.
Ensure the MSP Questionnaire is completed for every Medicare registration.
Coordinate with physician office staff, schedulers, and hospital departments to prepare information before patient arrival.
Use online programs to verify insurance eligibility and benefits, document findings on patient accounts, and assist with pre-authorizations and pre-certifications when requested by the Director.
Communicate with physician office staff to resolve authorization issues and coordinate registrations.
Collect applicable co-payments, deductibles, and co-insurance when patients arrive for service.
For emergency registration work, ensure compliance with EMTALA.
Log cash collected, generate receipts, and maintain balanced cash; meet monthly cash collection goals established with department leadership and the 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 as requested.
Perform front-desk reception and greeting duties as needed.
For Community Hospital Only, verify medical licensure and check Medicare Sanctions websites for non-credentialed physicians ordering outpatient diagnostic tests.
Provide consistently high-quality customer service and communication to internal and external contacts, patients, and families.
Meet established individual and team quality and productivity standards; track and monitor productivity as requested.
Adapt positively to changes in policies, procedures, operations, and insurance requirements, and foster team-based results.
Follow time and attendance standards and provide required notice of absence or tardiness.
Protect patient confidentiality in accordance with HIPAA guidelines.
Demonstrate required competencies annually through testing or evidence from quality reviews and direct observation.
Keep the Department Director or Team Lead informed of registration delays.
Stay current on scheduling, registration, insurance verification, and related processes to cover for absent team members.
Perform other duties as assigned.