Patient Access Representative

Cape Cod Healthcare•Hyannis, MA

About The Position

The Patient Access Representative is responsible for interviewing patients and/or their representatives to gather necessary information for the registration process, ensuring accuracy, confidentiality, and integrity of the database. This role involves coordinating and communicating registration activities with various hospital departments to support effective patient care. The representative will initiate and maintain organized files, contact patients and insurers to obtain reimbursement information, verify benefits, and secure pre-certifications. They must maintain knowledge of departmental policies to ensure maximum reimbursement and attend meetings as requested. Additionally, the role ensures timely patient placement, processes admissions, discharges, and transfers, and explains and processes patient payments such as co-pays, co-insurance, and deductibles. They will also provide information on Health Care Proxy, Advanced Beneficiary Notice, Important Medicare Message forms, and financial issues, referring patients to a Financial Counselor when appropriate. Service excellence is a key component of this role, along with performing other assigned duties.

Requirements

Ability to read, write and communicate in English at the level of a high school graduate.
Ability to type at the rate of 25 WPM as demonstrated by a timed test.
Computer skills to perform the job functions in a satisfactory, accurate and productive manner.
Successful passage of a Medical Terminology course or successful passage of Medical Terminology challenge exam.
Ability to work independently and under pressure.

Responsibilities

Interview patient and/or patient representative to obtain required information necessary to complete the registration process in the hospital information system and maintains the accuracy, confidentiality and integrity of the automated database.
Coordinate and communicate accurate and updated registration/admission/and pre-admission activities with Medical Records, Care/Case Management, Utilization Management, Physicians' offices, Patient accounts, and any other hospital departments, as may be required, to support the appropriate, accurate, safe and effective patient care.
Initiate and maintain organized files and records, related to orders, payer authorizations, booking slips, schedules, and others per department procedure.
Contacts patients, employers, insurers and patient representatives to obtain insurance and other information necessary to secure hospital reimbursement, verifies benefits and pre-certifies all insurance plans to ensure maximum reimbursement to the hospital.
Verifies benefits, utilizing insurance verification systems. Obtains referrals and authorizations required and documents complete information, along with approved bed status, if applicable, in the computer system. Obtains pre-certifications in a manner to ensure maximum allowable reimbursement to the hospital.
Maintains a thorough knowledge of departmental policies and procedures to ensure maximum reimbursement to the hospital.
Attends departmental and other meetings as requested by the immediate supervisor.
Ensure timely placement of patients in the most effective and appropriate manner. Process admissions, discharges and transfers of all Hospital patients, per department procedures.
Explain and process payments from patients, which may include but not limited to co-pays, co-insurance, and deductibles
Follows department procedures related to securing payment information and providing patient receipts.
Provide information to patient and/or representative on: Health Care Proxy, Advanced Beneficiary Notice, Important Medicare Message (IMM) forms, Financial issues and refers to Financial Counselor if appropriate. Obtain completed forms as available.
Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers.
Perform other work related duties and activities as assigned or requested by manager/supervisor.