OP/ Specialty Patient Access Representative (Full Time, Days)

St. Luke's University Health Network•Easton, PA

7d•Hybrid

About The Position

The Patient Access Representative is responsible for the entire scope of the registration process for patients seen at St. Luke's University Health Network, in outpatient and/or Emergency Department locations. This includes, but is not limited to, correctly identifying patients, transcribing orders, completing registration screens, entering diagnosis and provider information, verifying insurances, point of service cash collections, work queues, etc. Communicates and coordinates with SLPG practices, clinical/diagnostic departments, and various revenue cycle departments to ensure excellent patient experience, clean claim submission, and payment for services. May require occasional travel between campuses or regional locations.

Requirements

High school graduate or equivalent required.
Excellent customer service and interpersonal skills required.
General computer experience and ability to type fluently, accurately, and quickly required.

Nice To Haves

Certificate/Degree in health care related field preferred.
Insurance background preferred.
Knowledge of medical terminology preferred.
Previous medical administrative experience and/or health care related education courses preferred.
Knowledge of health information system (epic) preferred.

Responsibilities

Correctly identify/validate patients in the hospital information system to maintain the integrity and accuracy of electronic medical records. Identify and report any instances of possible identity theft situations to the clinical department and leadership for appropriate escalation.
Maintain knowledge and education of network policy on Patient Identification including Mark for Merge, Chart Corrections, and Patient Look-Up.
Responsible for the patient registration (pre-reg and post-reg needs) including demographics, emergency contact, transcribing diagnostic orders, primary care and referring provider, diagnosis, insurance and guarantor verification, real-time insurance eligibility, point of service cash collections. This also includes patient, account, and claim edit level work queue errors related to registration. Can require contacting provider office, reviewing patient medical chart for diagnosis and medical necessity information.
Cross-train in all areas of location or region. Campus locations must be cross-trained in outpatient and Emergency Department areas. Outpatient (off-campus) locations must be cross-trained for all locations if any different nuances.
Greet and direct patients and visitors for the entire facility. Always provide friendly and courteous service to community and co-workers. Responsible for monitoring and enforcing visitor policy for the entity (if applicable).
Answer internal and external calls on the main department/facility line and dispense appropriate information and answer questions regarding the facility and its services.
Promote and help increase usage of MyChart patient portal and patient self-service capabilities to ensure patients are personally engaging in their health care.
Oversee and assist patients with Welcome Kiosk and On My Way technology at network locations. Consists of self-scheduled patients online and monitoring the arrival process and patient’s journey throughout their visit.
Contact the SLPG practice or Network Prior Authorization Department to obtain required insurance referrals and pre-certs when not previously documented in chart prior to service to decrease denials for no authorization.
Obtain medical license Number, NPI and UPIN via appropriate website for all new provider entries for outpatient services to ensure results are routed accurately and claim submission/payment.