Patient Access Representative - Casual

Grande Ronde Hospital•La Grande, OR

2d•Onsite

About The Position

The Patient Access Representative is responsible for greeting, registering, and assisting patients in a courteous and professional manner. Under the general supervision of the Patient Access Manager, this role performs imperative duties, including but not limited to hospital admissions, registration, appointment scheduling, insurance verification, patient collections, switchboard communications and emergency communications. The Patient Access Representative plays a critical role in creating a positive first impression, combining excellent customer service skills with a solid understanding of healthcare administrative processes to facilitate a smooth and efficient experience for patients and visitors.

Requirements

High school graduate or GED required.
American Heart Association Basic Life Support (BLS) certification strongly recommended.
Minimum of one (1) year of experience in a healthcare or customer service setting.
Minimum one (1) year in GRH Patient Access department required.
Certified Healthcare Access Associate (CHAA) certification required.
Pass Patient Access Representative II competency module required (annually).
Minimum two (2) years in GRH Patient Access department required
Minimum six (6) months as a Patient Access Representative II in GRH Patient Access department.
Exemplary performance.
Pass Patient Access Senior Representative competency module required (annually).
Ability to communicate clearly and professionally with patients, families, and healthcare team members, both verbally and in writing.
Maintain a professional appearance and demeanor, exercise discretion when handling sensitive patient information, and represent the organization positively.
Skilled in using EHR systems, insurance web portals, Microsoft Office applications, and multi-line phone and paging systems (PBX).
Demonstrate strong multitasking capabilities while maintaining a high level of attention to detail in a fast-paced environment.
Flexibility to work various shifts, including weekends and holidays, as needed.
Understand and comply with EMTALA, HIPAA, CMS regulations, and organizational policies related to patient access and privacy.

Nice To Haves

Ability to occasionally lift and carry items weighing up to 20 pounds, such as files or office supplies.
Ability to read, analyze, and interpret written materials.
Ability to communicate effectively through reading, writing, and speaking in person or on telephone.
Must be able to work at a computer for extended periods, including frequent viewing of a computer screen and prolonged sitting.
Capable of performing effectively under pressure, managing stress constructively to meet organizational goals.
Must be able to perform the primary duties and responsibilities of the job with or without reasonable accommodation.

Responsibilities

Perform accurate patient registration by searching the Master Patient Index (MPI) completely in the Electronic Health Record (EHR), pre-register and register patients for scheduled and unscheduled services, ensuring all demographic and financial data is correctly entered.
Verify and obtain insurance information, check for necessary authorizations, and coordinate with staff to ensure insurance requirements are met before services are rendered.
Deploy and document legal and compliance forms such as Consent for Treatment, Notice of Privacy Practices (NPP), Medicare Outpatient Observation Notification (MOON), and CMS Important Message from Medicare (IMM).
Ensure Advance Beneficiary Notices (ABNs) or waivers are delivered to patients as needed, collect payments, when possible, conduct financial conversations with patients respectfully and document all financial conversations in the EHR.
Ensure compliance with Emergency Medical Treatment and Active Labor Act (EMTALA), Health Insurance Portability and Accountability Act (HIPAA), Joint Commission, Centers for Medicare & Medicaid Services (CMS), and internal hospital policies, maintaining patient confidentiality and handling sensitive information discreetly.
Greet and assist patients and visitors professionally, provide directions or escort services, and consistently deliver service following AIDET principles (Acknowledge, Introduce, Duration, Explanation, Thank You).
Actively seek solutions to issues with registration, insurance, or patient flow and escalate concerns appropriately, contributing ideas for continuous improvement.
Answer and direct incoming calls professionally, respond to emergency codes, document call events, and use daily call lists for contacting on-call providers.
Perform clerical tasks such as quality checks, maintaining waiting areas and workspaces, ordering supplies, and working EHR work queues to resolve registration issues.
Attend department meetings, complete assigned education and compliance training, and stay updated on insurance protocols and healthcare regulations.
Patient Access Representative II and Patient Access Senior Representative will provide support, training, and mentorship to Patient Access Representatives.
Patient Access Senior Representative will lead or participate in departmental projects and committees.
Patient Access Senior Representative will be able to cross cover all Patient Access functions.
Flexibility to work various shifts, including weekends and holidays, as needed.