Patient Access Representative - PRN

Trinity Health•Athens, GA

About The Position

This part-time, PRN position requires open availability during the week and on weekends and does not include benefits. 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 financial requirements are met, including Medicare medical necessity, payer pre-certifications, and referrals. It also provides general information to hospital users, patients, families, and physician offices. Responsibilities and qualifications may vary by functional level. PAR I is an entry-level role requiring at least one year of customer service experience; Patient Access experience is preferred. PAR II performs PAR I duties and is cross-trained to work in Pre-Service, the Emergency Department, and/or Bed Desk, with at least two years of hospital registration or insurance verification experience and knowledge of medical terminology and diagnostic and procedural coding. The Patient Access Account Specialist level requires at least two years of hospital registration or insurance verification experience and uses specialized expertise, data analysis, critical thinking, and problem-solving to support colleagues and leadership. This level may influence peers or direct a project or project team and is responsible for reviewing and editing items for correctness under payer guidelines, resolving issues, ensuring accurate billing, and processing payments promptly. The position also includes organizational and analytical work: researching, collecting, and analyzing information; identifying opportunities and developing solutions; collaborating on performance improvement; preparing analytical reports and educational materials; and supporting operational projects and leadership decisions with data, summaries, trends, and practical recommendations. The representative is expected to follow applicable laws, regulations, organizational policies, compliance standards, and safe work practices. A high school diploma or equivalent is required. HFMA CRCR or NAHAM CHAA certification is required within one year of hire.

Requirements

High school diploma or equivalent.
At least one year of customer service experience for the PAR I level.
At least two years of hospital registration or insurance verification experience for PAR II and Patient Access Account Specialist levels.
HFMA CRCR or NAHAM CHAA certification required within one year of hire.
Knowledge of medical terminology, diagnostic coding, and procedural coding is required for PAR II.
Ability to explain insurance benefits.
Ability to use multiple system applications for analysis, reporting, and developing educational materials.
Research, analytical, critical-thinking, and problem-solving skills to support operational initiatives and organizational objectives.
Ability to follow applicable laws, regulations, organizational policies, compliance requirements, and safe work practices.

Nice To Haves

Patient Access experience is preferred for PAR I.
Ability to secure necessary authorization as part of insurance verification.

Responsibilities

Provide patient-focused customer service.
Perform outpatient and/or inpatient registration and insurance verification.
Collect patient financial liability payments and ensure financial requirements are met, including Medicare medical necessity, payer pre-certifications, and referrals.
Provide general information to hospital users, patients, families, and physician offices.
For PAR II duties, cross-train and perform activities in Pre-Service, the Emergency Department, and/or Bed Desk.
Research, collect, compile, and analyze information for operational projects and initiatives.
Identify opportunities, develop solutions, and collaborate on performance improvement activities related to program efficiency and patient experience.
Distribute analytical reports and create reports and educational materials using system applications.
Synthesize and present data, including graphical presentations of trends and practical options or solutions, to support leadership decision-making and organizational strategy.
Use operational data and measurements to define and demonstrate progress, return on investment, and impacts.
For the Patient Access Account Specialist level, analyze, process, and edit items for correctness based on payer guidelines; resolve items; ensure claims are billed accurately; and process payments timely.
Maintain knowledge of applicable laws, regulations, organizational policies, compliance requirements, procedures, and guidelines, and follow safe work practices.