Representative I, Patient Access-Full time

Trinity Health•Davenport, IA

About The Position

As a Representative I at MercyOne, you provide patient-focused customer service and perform outpatient and/or inpatient registration and insurance verification. You collect patient financial liability payments and ensure patients meet financial requirements, including Medicare medical necessity, payer pre-certifications, and referrals. You also provide general information to hospital users, patients, families, and physician offices. This position is scheduled for 32 hours per week, from 11:00 a.m. to 7:30 p.m., with every other weekend and some holidays. The role supports the organization’s mission, values, vision, actions, and promise through workplace behaviors, practices, and decisions. It also includes research, analysis, reporting, process improvement, and collaboration to support program efficiency and patient experience. The Representative I uses multiple system applications to analyze information, create reports, and develop educational materials, while applying knowledge of organizational policies and processes to prioritize quality, confidentiality, and safety. The position researches and compiles information for operational projects, analyzes data and presents summaries and trends, and uses program measurements to demonstrate progress, return on investment, and impact. The role requires adherence to applicable laws, regulations, compliance requirements, policies, and safe work practices. The posting describes PAR I as an entry-level position. PAR II duties include PAR I responsibilities and cross-training in Pre-Service, the Emergency Department, and/or Bed Desk.

Requirements

PAR I: Minimum of one year of customer service experience.
PAR II: Minimum of two years of hospital registration or insurance verification experience upon hire.
PAR II: Knowledge of medical terminology, diagnostic coding, and procedural coding.
PAR II: Ability to explain insurance benefits.
Ability to demonstrate knowledge of departmental processes and procedures and readily acquire new knowledge.
Working knowledge of applicable federal, state, and local laws and regulations, and organizational compliance requirements, policies, procedures, and guidelines.

Nice To Haves

Patient Access experience is preferred.

Responsibilities

Provide patient-focused customer service.
Perform outpatient and/or inpatient registration and insurance verification.
Collect patient financial liability payments and ensure patients meet financial requirements, including Medicare medical necessity, payer pre-certifications, and referrals.
Provide general information to hospital users, patients, families, and physician offices.
Research, collect, and analyze information; identify opportunities, develop solutions, and lead issues through resolution.
Collaborate on performance improvement activities based on program efficiency and patient experience outcomes.
Distribute analytical reports.
Use system applications to perform analysis, create reports, and develop educational materials.
Research and compile information for ad hoc operational projects and initiatives.
Synthesize and analyze data, prepare detailed summaries and graphical presentations of trends, and recommend practical options or solutions for leadership decision-making.
Use program and operational data and measurements to define and demonstrate progress, return on investment, and impacts.
Maintain knowledge of applicable laws, regulations, compliance requirements, policies, procedures, and guidelines, and follow honest, ethical, professional, and safe work practices.
For PAR II, perform PAR I duties and cross-train in Pre-Service, the Emergency Department, and/or Bed Desk.