Patient Access Representative

Beth Israel Lahey Health•Plymouth, MN

10d•Onsite

About The Position

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. 40hpw; Day Shift 8a-430p Monday-Friday Patient Access: Pre-Surg Job Description: Beth Israel Deaconess Hospital-Plymouth recognizes Integrity, Respect, Trust, Teamwork and Excellence as the Core Values of our organization. It is the philosophy of BID-Plymouth to follow the LEAN methodology in order to provide the full continuum of health care services and the best quality patient centered care. Position Summary: Performs a variety of functions to support an accurate, safe and customer-focused patient access process. Ensures that all proper patient financial and demographic information is obtained and processed so BID Plymouth Hospital is fully reimbursed for clinical services provided. Handles patient questions and requests accurately and efficiently, ideally with first call resolution, or by making appropriate referrals to other departments, based on the original purpose of the question and any other questions or requests subsequently disclosed by the patient. Ensures that the patient experience in accessing healthcare at BID Plymouth Hospital is efficient and welcoming, and that patient confidentiality is respected and patient safety is preserved.

Requirements

HS Diploma
Prior experience in patient access, practice management or another related healthcare role.
Knowledge of healthcare billing, insurance verification, and authorization processes.
Strong understanding of healthcare compliance and regulatory requirements.
Excellent interpersonal and communication skills.
Proficient in using hospital information systems and related software.
Demonstrated ability to function independently with minimal supervision.
Possesses good decision-making skills and demonstrated ability to work under pressure, maintaining a helpful and courteous manner.

Responsibilities

Registration: Registers patients presenting for visits. Explains the registration process to patients and responds to patient questions. Processes patient co-payments, co-insurance, deductibles and balances due. Safeguards checks and receipts and reconciles cash drawer at end of each business day. Completes the Medicare Secondary Payer Questionnaire for each patient and adjusts patient coverage based on results. Instructs patients and obtains signatures on consent forms, financial forms and other documents required by the clinical department; scans, processes and records receipt of all documents collected during registration encounter. Counsels patients regarding non-covered services, obtaining signatures on Advance Notice Beneficiaries (ABNs), consents and waivers. Monitors patient waiting area for a smooth, efficient registration flow. Advises patients of potential delays and takes steps to ensure a pleasant patient experience. Completes registrations on inpatient units who may be missing information from their original registration Responds to patient concerns and potential patient safety issues accordingly. Recognizes health conditions that are a possible risk to others and adheres to appropriate established procedures to help contain risk. Assures a neat, orderly registration desk and patient waiting area, securing all confidential patient information.
Scheduling: Initiates patient scheduling activities by prioritizing and accessing a variety of sources, including patient phone calls and digital messaging, orders, scheduled order work queues. Utilizes a variety of information sources to schedule, reschedule and cancel patient appointments. Information sources include online questionnaires, offline materials and subgroup searches. Establishes working relationship with staff of assigned clinical departments. Understands and correctly applies unique clinical department scheduling protocols. Remains current on scheduling protocols and applies judgment, or seeks management assistance, to ensure safe patient care when clinical department scheduling protocols do not meet patient needs. Ensures all required key patient scheduling and registration information is captured and verified. Key information includes referring physician information, insurance coverage, demographics and contact information. Identifies and communicates to Patient Access management issues that may impact the timeliness and accuracy of patient appointments and subsequent patient care. Strictly follows confidentiality and equipment security and safeguarding guidelines when working in a remote setting. Maintains productivity, quality and accuracy levels and communicates regularly with the Supervisor and Manager.
Pre-Registration: Efficiently registers patients, capturing and verifying all required information in order to identify the patient, contact the patient, and receive proper reimbursement for services on initial claim submission. Ascertains, creates and assigns the guarantor for each patient, including personal/family relations, workers compensation insurance, third parties, behavioral health or others as required. Identifies records and verifies patient insurance coverage using real time eligibility (RTE); reviews the insurer’s response to each verification request and takes appropriate action based on this response. Applies the appropriate guarantor and insurance to each patient visit. Communicates financial clearance status to patients. Advises patients of contract status, self-pay status and payment responsibility and schedules patients with Financial Counseling as needed.
Organizational Requirements: Maintain strict adherence to the BID-Plymouth Hospital Confidentiality policy. Incorporate BID-Plymouth Code of Conduct Principles into daily activities. Comply with all BID-Plymouth Hospital Policies. Comply with behavioral expectations of the department and BID-Plymouth Hospital. Maintain courteous and effective interactions with colleagues and patients. Demonstrate an understanding of the job description, performance expectations, and competency assessment. Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards. Participate in departmental and/or interdepartmental quality improvement activities. Participate in and successfully completes Mandatory Education. Perform all other duties as needed or directed to meet the needs of the department. It is understood that this is a summary of key job functions and does not include every detail of the job that may reasonably be required.