Patient Access Representative

Brown Medicine•Providence, RI

8d•$18 - $30•Onsite

About The Position

Under the general supervision of the Supervisor, the Patient Access Representative interviews and registers inpatient, observation, emergency, and outpatient patients. The role collects demographic, insurance, and related financial information and enters it into the hospital’s online computer system. It initiates, reviews, and follows up on patient accounts to support accurate billing, verifies demographic and insurance information, and obtains referrals as required. The role is expected to model Brown University Health’s values of Compassion, Accountability, Respect, and Excellence, and its core Success Factors: Instill Trust and Value Differences, Patient and Community Focus, and Collaborate. The representative greets and directs patients, families, and visitors; explains hospital forms and procedures; verifies coverage, benefits, referrals, authorizations, and expected payments; collects and documents payments; and coordinates financial clearance with patients, insurers, and internal departments. The role also prepares registration paperwork, supports patient identification and admission processes, assists with bed control when needed, and protects patient privacy and confidentiality. Assignments may require coverage at hospital-based admitting, emergency, outpatient, or off-site registration locations. This position is based at The Miriam Hospital in Providence, Rhode Island. The stated pay range is $18.13–$29.90. The work shift is day, with eight daily hours, and the schedule is off every other weekend and holidays.

Requirements

High school diploma or equivalent.
Knowledge of medical terminology, third-party insurance information, and standard office computer applications.
Typing and data-entry skills and PC experience.
Six to twelve months of previous third-party billing or hospital registration experience.
Third-party billing knowledge.

Nice To Haves

Knowledge of third-party payer verification and authorization processes.

Responsibilities

Greet and direct patients, families, and visitors promptly and courteously.
Interview patients or representatives to obtain complete and accurate demographic, insurance, and personal or financial information; follow up on missing information with patients, representatives, employers, nursing homes, or other facilities.
Complete patient registration for inpatient, observation, emergency, and outpatient services, enter or verify information in hospital systems, and ensure patients are properly identified.
Verify insurance coverage, benefits, primary and secondary insurers, primary care physician information, referrals, authorizations, and other information needed to secure payment; contact insurers or companies when information is missing.
Record insurance information and financial notes, complete lien forms when applicable, and update documentation and financial-clearance status in the relevant systems.
Determine self-pay balances and expected payments, collect and document copayments and other payments, issue receipts, and refer patients to Patient Financial Advocates when appropriate.
Explain and obtain signatures for required consent, financial, insurance, privacy, and patient-rights forms; provide general hospital information and distribute applicable brochures.
Prepare registration records and required paperwork, including plates, bracelets, face sheets, admission documents, and other patient documentation.
Use scheduling and workflow reports and communicate with service departments, Financial Counselors, the Pre-Registration Office, and other teams to obtain orders, authorizations, or missing information.
Ask patients about Advance Directives, include documentation with admission paperwork, and explain and obtain signatures for Advance Beneficiary Notices when required.
Perform medical-necessity checks and distribute payment-policy information according to hospital policy and established criteria.
Notify physicians’ offices of emergency department arrivals or hospital admissions as required by policy.
Upgrade observation accounts to inpatient status when appropriate and complete other account-status changes and transfers.
Pre-admit or pre-register patients when assigned; verify information with insured patients, review eligibility reports, and prepare paperwork before arrival.
Review outstanding balances and financial-clearance needs, arrange or collect prepayments when applicable, and refer patients unable to meet financial obligations to Patient Financial Advocates.
Review and correct third-party payer eligibility reports and complete real-time status transfers.
Authorize occupancy and collect applicable private-room differentials; review bed-transfer information and monitor in-house balances, Medicare days, and Lifetime Reserve Days when applicable.
Review accounts before discharge, complete missing patient documentation, and direct patients to Patient Advocates when financial clearance is incomplete.
Provide bed control when needed, coordinate patient-room assignments with nursing, monitor bed availability and status, and coordinate bed cleaning with Environmental Services.
Review newly assigned medical record numbers for duplicates and report duplicates using the appropriate form.
Attend and participate in staff meetings; provide coverage at assigned registration locations as needed.
Protect patient privacy and confidentiality, use department equipment and technology, and perform other related duties supporting department operations.