Pre-Access Representative(Full-Time, Days)

Rochester Regional Health

6d•$19 - $29•Hybrid

About The Position

Key Responsibilities: Scheduling Procedures • Answers phones from patients/customers professionally and responding to patient/ customer complaints. • Performs correct name inquiry and identifies patient according to policy and procedure without errors • Schedules patients/customers based on scheduling guidelines and medical appropriateness. • Receives a high volume of inbound calls with varying degrees of questions and concerns. • Obtaining and collecting all necessary information from the patient/ customer to schedule and register the patient for an appointment. • Consults with referring physician’s office to ensure written and/ or electronic orders exist and obtain them as needed. • Collects patient financial data, insurance, authorizations, and reference numbers. • Collects complete demographic information of patient including address, phone number. • Collects medical information to include patient complaint Revenue Cycle • Views insurance card(s) and scans into computer system reviewing for mandatory precertification and/or other third party payer requirements • Obtains Inpatient/ Observation patients precertification’s • Re works accounts to ensure accurate patient statuses • Collects complete financial information to include payer name, identification number, group number, subscriber name, guarantor name and address, and precertification numbers • Selects appropriate financial class and insurance code • Performs online real-time eligibility verification and registration scrub via AHIqa and makes changes to registration errors accordingly and in a timely fashion • Identifies an • Screens for insurance edibility via insurance websites, where appropriate • Completes Medicare Secondary Payer Questionnaire for all Medicare-eligible patients • Completes all admission forms required by Medicare • Verifies third party payer benefits and Worker’s Compensation according to departmental policy and procedure • Collects any patient-pay balances such as copay, co-insurance, or deductible at time of registration • Refers patient to Patient Financial Advocacy Program when appropriate and per departmental procedure • Balances cash draw, completes cash receipt, issues patient receipts and secures safe daily with no exceptions Registration/Pre-Registration • Interviews the patient and/or family member either in person or by telephone to collect demographic, financial, and medical information • Performs correct name inquiry and identifies patient according to policy and procedure without errors • Collects complete demographic information of patient including address, phone number, and employer • Collects medical information to include patient complaint • Explains consent information, obtains signatures, witnesses (legibly) with no omissions • Obtains copy of patient identification document(s) • Completes registration process within five minutes for preregistered patients and ten minutes for non-preregistered • Contacts physician offices to obtain and confirm patient information Customer Service • Practices proficient customer service skills by greeting and treating all patients and staff with respect and discretion • Capable of empathizing with the circumstances of patients and families while maintaining and objective approach to the disposition of each account • Provides and explanation of any patient wait and responds to all patient requests. Notified manager of any patient wait times longer than 15 minutes. • Greets each patient and identifies self by name and role • Notifies the manager of incidents, errors or patient complaints • Maintains patient privacy and confidentiality at all times according to established procedures • Assess environment for safety hazards, which could harm patients, visitors, or other hospital employee’s and reports any found to facilities/housekeeping/manager • Exhibits professionalism in appearance, speech and conduct Development • Provide orientation and training of new staff • Attend Patient Access Meetings, Training Sessions, etc • Attend and actively participate in required and voluntary in-service educations • Participate in performance improvement within the organization and department

Requirements

Associate’s degree or higher in healthcare administration, business administration, or related field desired
At least 1-3 years of customer service, administrative, and/or data entry experience preferred
One to two years of previous experience in hospital related field preferred
Experience with database software applications desired
Basic knowledge of the following: o Medical Terminology o EHR Programs (e.g. Meditech, eClinicalWorks, Medhost) o ICD-10, CPT, HCPCS codes and coding processes o Hospital billing processes and reimbursement
Incumbent must possess superb customer service, teamwork, and conflict resolution skills
Ability to learn and operate computer systems, printer, fax
Strong attention to detail
Efficient time management skills and ability to multi-task
Excellent writing, oral, and interpersonal communication skills
Exceptional organizational, planning, coordination and collaborating skills
Strong understanding and comfort level with computer systems
Ability to work under stress
Work in fast pace setting
Critical thinking skills
Knowledgeable of HIPPA regulations.
High School Diploma or GED required

Responsibilities

Answers phones from patients/customers professionally and responding to patient/ customer complaints.
Performs correct name inquiry and identifies patient according to policy and procedure without errors
Schedules patients/customers based on scheduling guidelines and medical appropriateness.
Receives a high volume of inbound calls with varying degrees of questions and concerns.
Obtaining and collecting all necessary information from the patient/ customer to schedule and register the patient for an appointment.
Consults with referring physician’s office to ensure written and/ or electronic orders exist and obtain them as needed.
Collects patient financial data, insurance, authorizations, and reference numbers.
Collects complete demographic information of patient including address, phone number.
Collects medical information to include patient complaint
Views insurance card(s) and scans into computer system reviewing for mandatory precertification and/or other third party payer requirements
Obtains Inpatient/ Observation patients precertification’s
Re works accounts to ensure accurate patient statuses
Collects complete financial information to include payer name, identification number, group number, subscriber name, guarantor name and address, and precertification numbers
Selects appropriate financial class and insurance code
Performs online real-time eligibility verification and registration scrub via AHIqa and makes changes to registration errors accordingly and in a timely fashion
Screens for insurance edibility via insurance websites, where appropriate
Completes Medicare Secondary Payer Questionnaire for all Medicare-eligible patients
Completes all admission forms required by Medicare
Verifies third party payer benefits and Worker’s Compensation according to departmental policy and procedure
Collects any patient-pay balances such as copay, co-insurance, or deductible at time of registration
Refers patient to Patient Financial Advocacy Program when appropriate and per departmental procedure
Balances cash draw, completes cash receipt, issues patient receipts and secures safe daily with no exceptions
Interviews the patient and/or family member either in person or by telephone to collect demographic, financial, and medical information
Explains consent information, obtains signatures, witnesses (legibly) with no omissions
Obtains copy of patient identification document(s)
Completes registration process within five minutes for preregistered patients and ten minutes for non-preregistered
Contacts physician offices to obtain and confirm patient information
Practices proficient customer service skills by greeting and treating all patients and staff with respect and discretion
Capable of empathizing with the circumstances of patients and families while maintaining and objective approach to the disposition of each account
Provides and explanation of any patient wait and responds to all patient requests. Notified manager of any patient wait times longer than 15 minutes.
Greets each patient and identifies self by name and role
Notifies the manager of incidents, errors or patient complaints
Maintains patient privacy and confidentiality at all times according to established procedures
Assess environment for safety hazards, which could harm patients, visitors, or other hospital employee’s and reports any found to facilities/housekeeping/manager
Exhibits professionalism in appearance, speech and conduct
Provide orientation and training of new staff
Attend Patient Access Meetings, Training Sessions, etc
Attend and actively participate in required and voluntary in-service educations
Participate in performance improvement within the organization and department