Patient Access Representative - PRN

Trinity Health•Lavonia, 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. The position supports Trinity Health’s mission, values, vision, actions, and promise through its behaviors, practices, and decisions. It researches and analyzes information, supports performance improvement, distributes analytical reports, uses multiple system applications, and applies knowledge of departmental processes and Trinity Health policies. Responsibilities may include compiling operational data, preparing summaries and graphical presentations, identifying trends and practical solutions, and supporting leadership decisions. The posting describes several functional role levels. PAR I is an entry-level role. PAR II performs PAR I duties and is cross-trained in areas such as Pre-Service, the Emergency Department, and/or the Bed Desk. A Patient Access Account Specialist uses specialized knowledge to support organizational areas, analyze and process items for correctness under payer guidelines, resolve items, help ensure accurate claims, and process payments timely. The role requires maintaining working knowledge of applicable laws and regulations, Trinity Health’s Integrity and Compliance Program and Code of Conduct, and other policies and guidelines to support ethical conduct and safe work practices. No benefits are aligned with this position.

Requirements

High school diploma or equivalent.
HFMA CRCR or NAHAM CHAA certification required within one year of hire.
For PAR I: at least one year of customer service experience.
For PAR II: at least two years of hospital registration or insurance verification experience upon hire.
For PAR II: knowledge of medical terminology, diagnostic coding, and procedural coding, and ability to explain insurance benefits.
For Patient Access Account Specialist: at least two years of hospital registration or insurance verification experience.
Open 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.
Demonstrate Trinity Health’s mission, values, vision, actions, and promise in work behaviors, practices, and decisions.
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.
Distribute analytical reports.
Use multiple system applications to analyze information, create reports, and develop educational materials.
Research and compile information for ad hoc operational projects and initiatives.
Synthesize and analyze data; provide detailed summaries and graphical presentations that illustrate trends and recommend practical options or solutions.
Use program and operational data and measurements to define and demonstrate progress, return on investment, and impact.
Maintain working knowledge of applicable laws, regulations, compliance requirements, policies, procedures, and guidelines.
For PAR II, perform PAR I duties and cross-trained activities in Pre-Service, the Emergency Department, and/or the Bed Desk.
For Patient Access Account Specialist duties, analyze, process, and edit items for correctness based on payer guidelines; resolve items; ensure claims are billed accurately; and process payments timely.