Patient Access Representative-AMO-Medical Records

Cherokee Nation•Salina, OK

About The Position

The Patient Access Representative at the AMO Salina Clinic collects patient and insurance information, verifies coverage and eligibility, maintains accurate electronic health records, obtains required consent, privacy, and authorization forms, and schedules, cancels, and reschedules appointments. The role serves as a front-line contact for patients and visitors, providing courteous assistance and resolving issues professionally. It also coordinates with patients, providers, insurers, and other departments to support registration, billing, referrals, and authorization processes.

Requirements

High school diploma or GED, or at least six months of specialized training, education, or experience.
At least six months of experience in a related field.
Ability to read and comprehend simple instructions, short correspondence, and memos; write simple correspondence; and present information effectively in one-on-one and small-group settings.
Ability to perform arithmetic with whole numbers, common fractions, and decimals; compute rates, ratios, and percentages; and interpret bar graphs.
Knowledge of database software.
Ability to apply common-sense understanding to written, oral, or diagrammed instructions and address problems involving several concrete variables in standardized situations.
No certificates, licenses, or registrations required.

Nice To Haves

Experience with Medicaid, Medicare, and third-party billing and guidelines is preferred.

Responsibilities

Greet and assist patients and visitors in person and by phone; address general problems or complaints, make appointment reminder calls, route calls, and take accurate messages.
Determine healthcare eligibility for new patients to the Cherokee Nation Health System by obtaining a CBID card or other documentary proof of membership in a federally recognized tribe.
Help patients complete new or updated forms and obtain required signatures for inpatient, outpatient, emergency, and after-hours services.
Interview new and existing patients to collect registration information, including by phone for pre-registration.
Verify patient billing information through automated processes, registration interfaces, and contact with patients or payers as needed.
Scan third-party health insurance cards and explain the need to bill for services rendered.
Maintain knowledge of and comply with the Privacy Act, HIPAA, and other applicable confidentiality rules and regulations.
Enter Medicare, Medicaid, and private or commercial insurance information into the electronic records system.
Review notes and communicate with Patient Benefits Advocates or Coordinators about billing information and coordination of eligibility and benefits.
Schedule, cancel, and reschedule appointments; use appropriate scheduling designations and queues to support timely scheduling.
Use the automated appointment reminder application and reports daily.
Ensure appointment slots have time allotments appropriate to those defined by medical staff.
Send clinic or department correspondence to patients.
Meet acceptable production and quality assurance standards.
Serve as a front-line point of contact for patients.
Use computerized programs and databases to enter, modify, and retrieve sensitive information in electronic health record, scheduling, registration, and reporting systems.
Monitor scheduling queues and wait lists to ensure referrals are handled appropriately and promptly.
Assess patient status and obtain authorization for hospitalization and outpatient services before services are rendered.
Provide retroactive reviews and appeals to insurance companies as needed.
Answer calls from insurance companies, physician offices, hospitals, and patients with exemplary customer service.
Document pre-certification numbers in the electronic health record and designated areas so other departments can readily access the information.
Coordinate with providers, case management, insurance carriers, patient access billing, and patients to secure authorizations, payments, or services.
Expedite emergency referrals based on medical personnel recommendations.
Communicate effectively and politely with patients when rescheduling appointments.
Complete daily productivity log forms.
Use strong interpersonal and relationship skills to provide exceptional service to patients and internal and external coworkers.
Direct patient inquiries to appropriate personnel, including medical personnel.
Verify patient demographic, insurance, emergency contact, and eligibility information for accuracy and completeness.
File and retrieve applications and records according to established procedures; research missing records, tabulate data, and assemble or repair records and files as needed.
Order and issue supplies as appropriate.
Operate copiers, fax machines, and other office equipment.
Assist with and train other or new team members.
Follow call-in procedures established by the supervisor.