OP Patient Access Representative (Full Time, Days)

St. Luke’s University Health Network•Easton, PA

12d•Onsite

About The Position

The Patient Access Representative is responsible for the entire scope of the registration process for patients seen at St. Luke's University Health Network, in outpatient and/or Emergency Department locations. This includes, but is not limited to, correctly identifying patients, transcribing orders, completing registration screens, entering diagnosis and provider information, verifying insurances, point of service cash collections, and managing work queues. The role involves communicating and coordinating with SLPG practices, clinical/diagnostic departments, and various revenue cycle departments to ensure an excellent patient experience, clean claim submission, and payment for services. Occasional travel between campuses or regional locations may be required.

Requirements

High school graduate or equivalent required.
Excellent customer service and interpersonal skills required.
General computer experience and ability to type fluently, accurately, and quickly required.

Nice To Haves

Certificate/Degree in a health care related field preferred.
Insurance background preferred.
Knowledge of medical terminology preferred.
Previous medical administrative experience and/or health care related education courses preferred.
Knowledge of health information system (epic) preferred.

Responsibilities

Correctly identify and validate patients in the hospital information system to maintain the integrity and accuracy of electronic medical records.
Identify and report any instances of possible identity theft situations to the clinical department and leadership for appropriate escalation.
Maintain knowledge and education of network policy on Patient Identification, including Mark for Merge, Chart Corrections, and Patient Look-Up.
Perform patient registration (pre-registration and post-registration needs), including demographics, emergency contact, transcribing diagnostic orders, primary care and referring provider, diagnosis, insurance and guarantor verification, real-time insurance eligibility, and point-of-service cash collections.
Address patient, account, and claim edit level work queue errors related to registration.
Contact provider offices and review patient medical charts for diagnosis and medical necessity information.
Cross-train in all areas of the location or region, including outpatient and Emergency Department areas for campus locations, and all outpatient locations if there are different nuances.
Greet and direct patients and visitors for the entire facility, providing friendly and courteous service.
Monitor and enforce the visitor policy for the entity (if applicable).
Answer internal and external calls on the main department/facility line, providing appropriate information and answering questions regarding the facility and its services.
Promote and increase usage of the MyChart patient portal and patient self-service capabilities.
Oversee and assist patients with Welcome Kiosk and On My Way technology at network locations, monitoring the arrival process and patient journey.
Contact the SLPG practice or Network Prior Authorization Department to obtain required insurance referrals and pre-certifications when not previously documented in the chart prior to service to decrease denials for no authorization.
Obtain medical license number, NPI, and UPIN via the appropriate website for all new provider entries for outpatient services to ensure accurate results routing and claim submission/payment.