Patient Access Representative - Nelson Clinic - Ophthalmology - Days

VCU Health • Richmond, VA

2d

About The Position

The Patient Access Representative delivers high-quality customer service to patients of all ages, their families, visitors, medical staff, clinicians and co-workers, ensuring all interactions are courteous, timely and respectful. The Patient Access Representative handles all business functions in an assigned clinical department area to include reception, scheduling, and registering patients for appointments and/or procedures. This position also secures the appropriate patient information; ensures that registration data is correct and accurate; validates insurance eligibility, ensuring accurate data entry; collects co-pays, and supports financial counseling and financial clearance, as necessary.

Requirements

• High School Diploma or equivalent
• Demonstrated experience using computers, Microsoft Office applications, and web-based platforms
• Able to perform daily activities with minimal supervision: being self-directed in the accomplishment of routine activities.

Nice To Haves

• Associates or Bachelor’s Degree in Accounting, Finance, Business Administration, Healthcare Administration or closely related field from an accredited program.
• Work experience with medical insurance, HMO, managed care, electronic medical billing/order entry/registration systems, and appointment scheduling.
• Previous work experience in a healthcare setting, and knowledge of medical terminology.
• Depending on assignment, may be required to work off-shifts and/or weekend and holidays.

Responsibilities

• Greet Patients/Answer Telephone Provides exceptional customer service by welcoming patients and visitors in a friendly, professional, and respectful manner. Ensures individuals are respected and informed, communicating clearly and effectively, and utilizing appropriate language resources as needed. Assists with traffic flow in and out of the clinic as needed. Addresses patient needs promptly, and maintains a courteous, professional tone at all times.
• Co-payment Collection & Registration Data Collects all patient co-payments and deposits accurately per payer, following department guidelines. Verifies and updates registration data, including demographic and insurance information. Copies and records insurance information per department standards. Follows department policies for cash handling, including cash reconciliation and deposit preparation.
• Referral Management Verifies insurance coverage and understands requirements for HMO, managed care, government and private plans. Secures required referrals/authorizations and links them correctly in the referral module. Obtains needed referrals and authorizations before scheduled procedures, tests, injections and surgeries. Communicates plan-specific referral/authorization requirements to patients and providers. Provides pre-payment guidance for self-pay patients and offers financial assistance. Prepares cost estimates, explains payment expectations and documents all interactions in the patient account.
• Appointment Scheduling, Lab & Test Order Entry Correctly schedules clinic appointments through the medical records software/communication platform. Transcribes physician orders accurately and completely (i.e. lab test, ancillary test) and records them in the appropriate system(s) according to the physician’s instructions and VCUHS policy. Coordinates the collection of pre-operative testing and paperwork, where appropriate.
• Patient Record/Verify Registration Data Maintains proficiency in all aspects of patient medical record keeping in an organized manner. Assists in preparation of the chart before the patient visits. If applicable, assists in breaking down the chart at the completion of the patient's visit. Ensures that all patients arrived in the appointment scheduling system before the end of the appointment day. Where appropriate, appointments are documented as “no-shows” or cancellations before the end of the appointment day. Obtains signatures and completes the required forms including those from managed care and other insurance plans.
• E-Documents Management & Scanning Obtains and scans all appropriate patient medical documentation.
• Miscellaneous Responsibilities Notifies supervisor of issues involving violation of VCUHS policies or procedures. Performs other duties as assigned and/or participates in special projects to support the mission of VCUHS and department.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED