Patient Access Representative

Southwest Health•Platteville, WI

8d•Onsite

About The Position

The primary responsibilities of the Patient Access Representative are to arrange for efficient and orderly registration of Emergency, Inpatients and Outpatients. A patient access representative ensures that accurate patient information is collected and that patients are aware of hospital policies and procedures. These duties will be performed in a “Customer oriented” professional manner.

Requirements

Must have a high school diploma, GED, or equivalent.
Six months to one year experience with customer relations required
Knowledge of basic office procedures/equipment and computer systems required
Familiarization with medical terminology and prior health care experience preferred

Nice To Haves

Certification in Basic Life Support (BLS) preferred.

Responsibilities

Registers patients for services performed at Southwest Health.
Ensures patient records are up-to-date: demographics, employer, and emergency contacts
Scans all necessary paperwork into system (face sheet, insurance card, patients’ order, Driver’s License, and any other signed documentation)
Gathers necessary patient information including outpatient physician orders, diagnosis, emergency notification numbers, and insurance information
Obtains necessary signatures on registration related documents.
Verifies insurance eligibility and benefits.
Obtains Medicaid eligibility from the online Forward Health program and changes the patients account accordingly.
Processes Medicare patients through the designated electronic verification program to obtain medical necessity for scheduled procedures.
Collects/requests out-of-pocket liabilities from patients upfront and applies, adjusts, and reconciles daily point-of-service cash reports.
Refers patient accounts to financial counselors when further explanation/education is needed regarding denied authorizations, out-of-pocket liabilities, coverage options, or payment plans.
Cross-trains and is well versed in a minimum of three areas of patient access.
Obtains signature from patient on Advance Beneficiary Notice (ABN) if the procedure didn’t pass medical necessity.
Exhibits professionalism in appearance, speech, and conduct.
Ensures that services are provided in accordance with state and federal regulations.
Adheres to Southwest Health’s value-based behavior standards.
Understands and adheres to Southwest Health compliance and HIPAA standards as they appear in the Corporate Compliance Policy, Code of Conduct and Conflict of Interest Policy.
Performs other duties and responsibilities as requested or required.