Patient Access Representative PRN

United Surgical Partners International Inc (USPI)•Oklahoma City, OK

About The Position

The Patient Access Representative is responsible for complete and accurate registration of patients receiving services at the facility. The role gathers and enters patient information, verifies benefits for patients who are not preregistered, obtains required signatures, and collects copayments, deductibles, and coinsurance at the time of service. The representative supports an efficient, timely registration process that reflects the facility’s customer service philosophy. The position works with patients, physician offices, schedulers, clinical departments, insurers, and other hospital departments to prepare for patient visits and resolve registration or authorization issues. It also includes front-desk reception duties, cash handling, adherence to privacy and regulatory requirements, and maintaining the knowledge needed to cover registration processes across the team.

Requirements

High school diploma or equivalent required.
Ability to type accurately at 40 words per minute, complete forms and simple correspondence, handle payment transactions, and enter data.
Excellent verbal and written communication and interpersonal skills.
Ability to manage multiple tasks with short timelines, prioritize and organize work, and complete assignments accurately and on time.
Ability to interact and communicate effectively, tactfully, and diplomatically with patients, families, medical staff, coworkers, employers, and insurance representatives.
Pleasant disposition, positive attitude, and ability to maintain a cordial and professional approach during stressful periods.
Skill using basic office equipment, including a computer, photocopier, telephone, fax machine, and calculator.
Ability to think and act decisively in a timely manner.
Ability to maintain operational knowledge of insurance requirements needed to achieve optimal reimbursement.
Ability to meet the stated physical demands, including occasional lifting, carrying, pushing, or pulling of up to 10 pounds; occasional standing or walking; frequent keyboard use and dexterity; and the ability to talk, see, and hear.
Follow standard precautions in an environment with potential exposure to infections and communicable diseases, blood and body fluids, electrical equipment, and chemicals.

Nice To Haves

Two years of college preferred.
Experience in patient registration, verification, and authorization in a medical center or comparable institution preferred.
Working knowledge of governmental regulations and other reimbursement criteria preferred.

Responsibilities

Communicate with clinical departments or scheduling representatives to obtain scheduled appointments and orders before the service date.
Preregister at least 98% of scheduled patients at least three business days before arrival.
Obtain, validate, and accurately enter patient demographic and insurance information into the computer system, maintaining an accuracy rate above 95%.
Review the MPI to help avoid duplicate medical record numbers.
Obtain signatures on all forms and documents required by the hospital and by law.
Ensure the MSP Questionnaire is completed for every Medicare registration.
Coordinate with physician office staff, schedulers, and hospital departments to schedule and prepare required information before patient arrival.
Use online programs to verify insurance eligibility and benefits, document findings on patient accounts, and assist with obtaining pre-authorizations and pre-certifications when requested by the Director.
Communicate with physician office staff to resolve authorization issues and coordinate registrations.
Collect identified copayments, deductibles, and coinsurance when patients arrive for service.
When assigned to Emergency registration, ensure compliance with EMTALA for all patients.
Log cash collections, generate receipts, and maintain balanced cash.
Meet monthly cash collection goals determined collaboratively by the Department Director/Manager and CBO.
Obtain and copy or scan insurance cards and driver licenses.
Use the phone system professionally, transfer calls appropriately, and assist with internal calls when requested by the Department Director or Team Lead.
Perform front-desk reception and greeter duties as needed.
For Community Hospital, verify medical licensure and check Medicare Sanctions websites for non-credentialed physicians ordering outpatient diagnostic tests.
Demonstrate customer service and communication skills with internal and external contacts and help provide patients and families with a positive hospital encounter.
Meet established individual and team quality and productivity standards.
Adapt positively to changes in hospital policies, procedures, operations, and insurance requirements.
Support team-based results.
Follow attendance standards and provide required notice of absence or tardiness within departmental time frames.
Protect patient confidentiality and comply with HIPAA guidelines.
Demonstrate required competencies annually through testing or daily quality review and direct observation.
Track and monitor productivity as requested.
Keep the Department Director or Team Lead informed of delays in registration.
Maintain current knowledge of scheduling, registration, insurance verification, and other patient registration processes to provide coverage for team members.
Perform other duties as assigned.