PATIENT ACCESS REP, PRN,

Trinity Health•Lavonia, GA

About The Position

The Patient Access Representative provides patient-focused customer service and performs outpatient and/or inpatient registration and insurance verification. The role collects patient financial liability payments and ensures patients meet financial requirements, including Medicare medical necessity, payer pre-certifications, and referrals. It also provides general information to hospital users, patients, families, and physician offices. This is a part-time, PRN position with open availability during the week and on weekends. The position has no aligned benefits. Functional role responsibilities and qualifications vary by level: PAR I is entry-level; PAR II includes cross-training and work in Pre-Service, the Emergency Department, and/or Bed Desk; and Patient Access Account Specialists use specialized knowledge to support organizational areas and ensure accurate billing and timely payment processing. The role supports Trinity Health’s mission, values, vision, actions, and promise. It researches and analyzes information, supports operational projects and performance improvement, prepares analytical reports and summaries, and uses multiple system applications. It applies knowledge of relevant policies, processes, laws, regulations, and compliance guidelines while prioritizing quality, confidentiality, safety, and ethical professional conduct.

Requirements

High school diploma or equivalent.
HFMA CRCR or NAHAM CHAA certification required within one year of hire.
PAR I: Minimum of one year of customer service experience.
PAR II: Minimum of two years of hospital registration or insurance verification experience upon hire.
PAR II: Knowledge of medical terminology, diagnostic coding, and procedural coding; ability to explain insurance benefits.
Patient Access Account Specialist: More than two years of hospital registration or insurance verification experience.
Maintain working knowledge of applicable federal, state, and local laws and regulations, Trinity Health’s Integrity and Compliance Program and Code of Conduct, and other applicable policies and guidelines.

Nice To Haves

Patient Access experience is preferred for PAR I.
Medical terminology and knowledge of diagnostic and procedural coding.
Insurance verification experience, ability to explain benefits, and ability to secure necessary authorization.

Responsibilities

Provide patient-focused customer service.
Perform outpatient and/or inpatient registration and insurance verification.
Collect patient financial liability payments and ensure patients meet financial requirements, including Medicare medical necessity, payer pre-certifications, and referrals.
Provide general information to hospital users, patients, families, and physician offices.
Research, collect, compile, and analyze information for operational projects and initiatives.
Identify opportunities, develop solutions, and lead issues through resolution.
Collaborate on performance improvement activities based on program efficiency and patient experience outcomes.
Distribute analytical reports and prepare detailed summaries, including graphical presentations of trends and practical recommendations.
Use program and operational data and measurements to demonstrate progress, return on investment, and impacts.
Use multiple system applications to perform analysis, create reports, and develop educational materials.
Apply relevant policies, practices, processes, laws, regulations, and compliance guidelines to support quality, confidentiality, safety, and ethical conduct.
For PAR II, perform PAR I duties and cross-trained activities in Pre-Service, the Emergency Department, and/or Bed Desk.
For Patient Access Account Specialist, analyze, process, and edit items for correctness based on payer guidelines, resolve items, ensure claims are billed accurately, and process payments timely.