Patient Access Representative, Patient Access

Self Regional Healthcare•Greenwood, SC

About The Position

The Patient Access Representative performs scheduling, pre-certification, and benefit verification for inpatient, outpatient, and emergency care. The role requires responding quickly to customer needs and using independent judgment, ingenuity, and initiative with computers and other equipment. The representative works with staff, understands appropriate scheduling processes, and recognizes how those processes affect ancillary departments. The representative interviews patients and guarantors during registration, explains hospital policies and financial responsibilities, and obtains required signatures. The role ensures demographic and financial information is collected and accurately entered into the EPIC system in a timely manner. It also ensures required pre-certification or authorization is obtained in accordance with insurance company policies, determines estimated patient responsibility based on verified benefits, co-pays, and deductibles, and calculates estimated self-pay amounts due at registration. The representative serves as a main communication link among physicians, nursing and clinical staff, non-clinical staff, and the Patient Access Department to support appropriate scheduling and patient entry into and movement through the health care system. Performs other duties as assigned by the management team. The schedule is full-time, Monday through Friday, 8:30 a.m. to 5:00 p.m.

Requirements

High school diploma or equivalent.
Strong customer service experience.
Ability to communicate effectively both orally and in writing.
Working knowledge of medical terminology, ICD-10, and CPT coding.
Ability to build productive internal and external working relationships.
Basic analytical skills.
Strong organizational skills and attention to detail.
Ability to handle challenging customers professionally.
Ability to respond quickly to customer needs and exercise independent judgment, ingenuity, and initiative in using computers and other equipment.

Nice To Haves

General knowledge of and experience in the healthcare industry is preferred.

Responsibilities

Perform scheduling, pre-certification, and benefit verification.
Conduct patient and guarantor interviews for inpatient, outpatient, and emergency care registration.
Explain hospital policies and financial responsibilities and obtain required signatures.
Collect and accurately enter demographic and financial data in the EPIC system in a timely manner.
Obtain pre-certification and/or authorization in accordance with insurance company policies.
Determine estimated patient financial responsibility using verified insurance benefits, co-pays, and deductibles.
Calculate estimated self-pay amounts to be collected at registration.
Coordinate communication with physicians, nursing and clinical staff, non-clinical staff, and the Patient Access Department to support appropriate scheduling and patient flow through the health care system.
Work with staff and understand scheduling processes and their effects on ancillary departments.
Perform other duties as assigned by the management team.