Patient Access Representative

Brown Medicine•Providence, RI

5d•$18 - $30

About The Position

Under the general supervision of the Supervisor and in accordance with established policies and procedures, the Patient Access Representative interviews and registers inpatient, observation, emergency, and outpatient patients. The role gathers demographic, third-party insurance, and related financial information and enters it into the online hospital computer system. The representative initiates, reviews, and follows up on patient accounts to support accurate data collection and billing, verifies demographic and insurance information, and obtains referrals when required. Brown University Health employees are expected to model the organization's values of Compassion, Accountability, Respect, and Excellence, and demonstrate its core Success Factors: Instill Trust and Value Differences; Patient and Community Focus; and Collaborate.

Requirements

High school diploma or equivalent.
Knowledge of medical terminology, third-party insurance information, and standard office computer applications.
Typing and data-entry skills.
Six to twelve months of previous third-party billing or hospital registration experience.
Third-party billing knowledge.
Data-entry skills and PC experience.

Nice To Haves

Knowledge of third-party payer verification and authorization processes.

Responsibilities

Greet and direct patients, families, and visitors promptly and courteously.
Interview patients or their representatives to obtain complete and accurate personal, demographic, insurance, and financial information; follow up on missing information with patients, families, employers, nursing homes, or other facilities.
Register inpatient, observation, emergency, and outpatient patients in the hospital information system; verify and update information, establish active account status, and complete required financial-clearance documentation.
Verify insurance eligibility, coverage, benefits, primary care physician information, referrals, and authorizations using online tools or telephone contacts; identify primary and secondary insurers and update records when coverage changes.
Record insurance information, financial notes, liens, and other payment-related information in the system; complete required forms and documentation.
Determine self-pay balances and expected payments using reference tools, consult Patient Financial Advocates on complex cases, refer patients who cannot meet payment expectations, and collect and document required payments.
Explain consent, financial, insurance, privacy, and other hospital forms and policies; obtain required patient signatures and provide general hospital information.
Prepare and distribute patient registration records and required plates, bracelets, face sheets, and copies; identify patients according to department policy.
Use department scheduling and workflow reports and communicate with service departments, Financial Counselors, and the Pre-Registration Office to obtain orders, authorizations, and other required information.
Ask patients about Advance Directives, include them with admission paperwork when provided, and explain Advance Directives information when needed; explain and obtain signatures for Advance Beneficiary Notices as required.
Complete medical-necessity checks, distribute payment-policy brochures when criteria apply, and refer patients for assistance with coverage applications, community free services, or payment plans.
Notify physicians' offices of emergency department arrivals or hospital admissions according to policy.
Upgrade observation accounts to inpatient status when appropriate and according to policy.
Pre-admit or pre-register scheduled outpatients and inpatients; verify demographics, insurance coverage, referrals, benefits, and expected patient payment, and arrange or collect prepayments as appropriate.
Review and correct third-party payer eligibility reports, complete real-time status transfers, and update financial-clearance activity in the system.
Assemble paperwork in preparation for patient arrival and complete missing documentation with patients or family members when needed.
Authorize occupancy and collect private-room differentials when applicable; review bed-transfer lists and monitor in-house balances, Medicare days, and Lifetime Reserve Days.
Review accounts before discharge to resolve financial-clearance issues or direct patients to a Patient Financial Advocate according to policy.
Provide bed control support when needed by assigning appropriate rooms, notifying nursing units, coordinating bed assignments with Nursing, monitoring bed availability and status, and coordinating bed cleaning with ESD.
Review newly assigned medical record numbers for duplication and report duplicates using the appropriate form.
Attend and participate in staff meetings and provide coverage at hospital-based and off-site registration locations as needed.
Protect patients' privacy and confidentiality.
Use department equipment, including fax machines, phones, payment terminals, laptop PCs, and other technology.
Perform other related duties as required to support department operations.