Patient Access Representative, Patient Access, Resource Pool

Self Regional Healthcare • Greenwood, SC

5d

About The Position

The Patient Access Representative performs scheduling, pre-certification, and benefit verification. The role requires a fast response to customer needs and independent judgment, ingenuity, and initiative in using computers and other equipment. The representative works with staff, understands appropriate scheduling processes, and recognizes how those processes affect ancillary departments.

The representative conducts patient and guarantor interviews for inpatient, outpatient, and emergency care registration; explains hospital policies and financial responsibilities; and obtains required signatures. The role ensures demographic and financial data is entered accurately and promptly in the EPIC system, obtains pre-certification or authorization in accordance with insurance company policies, and estimates patient financial responsibility based on verified benefits, co-pays, deductibles, and self-pay amounts due at registration.

The representative manages the main line of communication among physicians, nursing, clinical and non-clinical staff, and the Patient Access Department to support appropriate patient scheduling and entry into and 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 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.

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 enter demographic and financial data accurately and promptly in the EPIC system.
• Obtain pre-certification and/or authorization in compliance with insurance company policies.
• Determine estimated patient financial responsibility using verified insurance benefits, co-pays, and deductibles, and calculate estimated self-pay amounts to collect at registration.
• Coordinate the main line of communication with physicians, nursing, clinical staff, non-clinical staff, and the Patient Access Department to support appropriate patient scheduling and movement through the health care system.
• Perform other duties assigned by the management team.

What This Job Offers

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