Patient Access Representative, Patient Access, Resource Pool

All Positions • Greenwood, SC

2d

About The Position

The Patient Access Representative performs scheduling, pre-certification, benefit verification, and registration for inpatient, outpatient, and emergency care. The role requires quick responses to customer needs, independent judgment, initiative, and effective use of computers and other equipment. The representative coordinates with staff and understands scheduling processes and their impact on ancillary departments.

The representative interviews patients and guarantors, explains hospital policies and financial responsibilities, and obtains required signatures. They accurately and promptly enter demographic and financial information into EPIC, obtain required pre-certifications or authorizations, and determine estimated patient financial responsibility from verified benefits, co-pays, and deductibles. They also calculate estimated self-pay amounts to collect at registration.

The position 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 movement through the health care system. Other duties may be assigned by the management team.

Requirements

• High school diploma or equivalent.
• Strong customer service experience.
• Ability to communicate effectively 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.

Nice To Haves

• General knowledge 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.
• Obtain and accurately enter demographic and financial data into the EPIC system in a timely manner.
• Obtain pre-certification and/or authorization required by insurance company policies.
• Determine estimated patient financial responsibility using verified insurance benefits, co-pays, and deductibles.
• Calculate estimated self-pay portions to collect at registration.
• Coordinate communication with physicians, nursing, 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.
• Perform other duties as assigned by the management team.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED