Patient Access Representative II

2 days ago

Framingham, United States Tenet Healthcare Full time
JOB SUMMARY Responsible for duties in support of departmental efficiencies which may include scheduling, registration, patient pre-admission and admission, reception, and discharge functions. Must obtain complete and accurate patient demographic information. Patient Access representatives also must employ proper, compliant patient liability collection techniques before, during, and after the date of service. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Greeting customers following Conifer Standards of Care, providing world-class customer service, completing full patient registration at the date of service, adhering to financial & cash control policies & procedures, and thoroughly explaining and securing Hospital & patient legal forms (i.e., Advance Directives, Conditions of services, Consent for treatment, Important Message from Medicare, EMTALA, etc.). Scanning Protected Health Information, creating and filing patient information packets/folders for upcoming Hospital services. May also assist with scheduling diagnostic procedures (entering data in scheduling system, providing customer with appointment instructions, and other tasks as needed). Educating patients about patient financial liabilities, employing proper, compliant patient liability collection techniques before, during, and after the date of service, performing Hospital cash reconciliation & secured payment entry in adherence to financial & cash control policies & procedures. Securing medical necessity checks/verification in accordance with Centers for Medicare & Medicaid services, verifying insurance, benefits, coverage & eligibility, completing assigned registration financial clearance work lists activities, obtaining insurance authorizations for scheduled & unscheduled Hospital services, and securing inpatient visit notification to payors. May also assist with scheduling and coordinating post-discharge care for patients. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Minimum typing skills of 35 wpm Demonstrated working knowledge of PC/CRT/printer Knowledge of function and relationships within a hospital environment preferred Customer service skills and experience Ability to work in a fast-paced environment Ability to receive and express detailed information through oral and written communications Course in Medical Terminology required Understanding of Third Party Payor requirements preferred Understanding of Compliance standards preferred Must be able to perform essential job duties in at least two Patient Access service areas including ED. Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors. Builds and maintains collaborative relationships with both internal and external Clients that lead to more effective communication and a higher level of productivity and accuracy. Must be able to appropriately interpret physician orders, medical terminology, and insurance cards while maintaining Conifer Standards of Care. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job. High School Diploma or GED required 0 1 year in a Customer Service role. 0 1 year administrative experience in a medical facility, health insurance, or related area preferred Some college coursework is preferred PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Must be able to sit at a computer terminal for extended periods of time Occasionally lift/carry items weighing up to 25 lbs. Frequent prolonged standing, sitting, and walking Occasionally push a wheelchair to assist patients with mobility problems. WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Hospital administration Can work in patient care locations which include potential exposure to life-threatening patient conditions. OTHER Must be available to work hours and days as needed based on departmental/system demands. Resolves Physician's office and Patient issues. May experience extreme patient volumes and uncooperative Patients. J-18808-Ljbffr

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