Patient Access Representative Jobs

About The Position

Requirements

• High School Diploma or GED- Required
• 1 year in a customer service role- Required
• Proficiency in Microsoft Applications (Excel, Word, PowerPoint)- Preferred
• 2 years experience in a medical facility, health insurance, or related medical field- Preferred
• Colleagues must have an understanding of computers, and competence in using computers and basic software programs.

Nice To Haves

• Medical Terminology Coursework- Preferred

Responsibilities

• Demonstrates ability to navigate web-based products or system applications required for registration or scheduling.
• Accurate identification of patient for direct data entry of required clinical, demographic, and insurance information to the electronic medical record during registration or for appointment booking of assigned diagnostic procedures.
• Provides general explanation of scheduled procedures and patient instructions that are necessary for conducting diagnostic medical services.
• Ensures system documentation specific to the patient visit is entered and accurately reflects activities related to patient or provider contact, order documentation, insurance verification, financial education, and payment.
• Provides explanation of legal forms and secures signature of patient/authorized party as required for services.
• Demonstrates basic understanding of compliance standards required within a healthcare environment including EMTALA and HIPAA-Privacy Patient Confidentiality regulations.
• Accurate identification and selection of insurance carrier in the patient medical record for specified dates of medical services.
• Navigation of web-based products or system applications to initiate and document insurance eligibility, benefit details, and authorization requirements.
• Performs required notifications to ensure insurance authorization for identified medical services, surgical procedures, and inpatient/observation stays are secured and documented.
• Demonstrates basic knowledge of CPT and ICD10 diagnosis coding documentation as required for medical services.
• Demonstrates basic knowledge of regulatory or Third Party Payer insurance requirements including Medicare, AHCCCS/Medicaid, Workers Comp and other commercial payers.
• Educates the patient on insurance eligibility, coverage, and availability of medical financial assistance program(s).
• Collects identified patient financial liabilities; performs secured payment entry and deposit/cash reconciliation steps.
• Performs PBX Switchboard functions as required for answering and routing of internal/external calls; paging codes and fire alarms; handles department call volumes as assigned to appropriately respond to requests from patients, providers, or other hospital departments.
• Acts as a resource for clinical departments for registration/scheduled services related to data entry of patient account fields, provider order requirements, and questions regarding insurance coverage or financial assistance.
• Responsible for reporting any safety-related incident in a timely fashion through the Midas/RDE tool; attends all safety-related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.
• Stays current and complies with state and federal regulations/statutes and company policies that impact the employee's area of responsibility.
• If required for the position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates.
• Completes all company mandatory modules and required job-specific training in the specified time frame.