Patient Access Representative

Trinity Health•Pontiac, MI

7d•Onsite

About The Position

The Patient Access Representative provides patient-focused customer service in the Emergency Department at Trinity Health Oakland. The position performs outpatient and/or inpatient registration and insurance verification, collects patient financial liability payments, and ensures patients meet financial requirements, including Medicare medical necessity, payer pre-certifications, and referrals. The representative also provides general information to hospital users, patients, families, and physician offices. The position may be filled at Patient Access level I or II based on the selected incumbent’s prior work experience and qualifications. A level I representative may be cross-trained and perform activities in Pre-Service, the Emergency Department, and/or Bed Desk. The position is fully on-site and works an evening shift from 12:00 p.m. to 8:30 p.m.

Requirements

High school diploma or GED.
HFMA CRCR or NAHAM CHAA certification required within one year of hire.
For Patient Access Representative II: at least two years of hospital registration or insurance verification experience.
For Patient Access Representative II: knowledge of medical terminology, diagnostic coding, and procedural coding.
For Patient Access Representative II: ability to explain insurance benefits.

Responsibilities

Provide patient-focused customer service in the Emergency Department.
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, and analyze information; identify opportunities, develop solutions, and lead through resolution.
Collaborate on performance improvement activities based on program efficiency and patient experience outcomes.
Distribute analytical reports and use system applications to analyze data, create reports, and develop educational materials.
Prepare detailed data summaries, including graphical presentations of trends and practical options or solutions, to support business strategy and leadership decision-making.
Use program and operational data and measurements to define and demonstrate progress, return on investment, and impacts.
Maintain knowledge of applicable laws, regulations, organizational compliance requirements, policies, procedures, and guidelines, and adhere to ethical, professional, and safe work practices.
For Patient Access Representative I: cross-train and perform activities in Pre-Service, the Emergency Department, and/or Bed Desk.