PATIENT ACCESS REPRESENTATIVE 1
1 month ago
What Makes Us Different?
With Our Lady of Lourdes, we offer career opportunities for people who have a calling to share their gifts and talents as part of our healing ministry. As part of the Franciscan Missionaries of Our Lady Health System, we are here to create a spirit of healing - and we invite you to join our team today if you would like to be part of that spirit. In addition to competitive salaries and generous benefits, we offer you something special - the chance to do God's work by helping to serve people in need throughout our community, every day. Additionally, you can expect:
Tuition reimbursement
Growth opportunities
Affordable employee benefits
A community culture where you don't feel lost in a large health system
Job Summary
The Patient Access Representative 1 (PAR1) is responsible for accurately registering inpatients, outpatients, and/or ER patients in the EMR, including validating patient information, verification of insurance coverage, calculation of and collection of patient co-insurance/deductibles/co-pays, authorization for services, and balancing of cash. the PAR1 ensures the patient's experience is best in class and demonstrates effective communication skills with patients and families, physicians, nurses, and insurance companies. The PAR1 is knowledgeable of and compliant with federal and state regulations related to acute-care patient registration.
Minimum Requirements
- Experience: 1 year relevant experience (registration, patient scheduling, customer service, billing, coding, finance, or accounting) in the healthcare industry. Related certification (Certified Coder, Certified Medical Assistant, or Certified Healthcare Access Associate) or bachelor's degree substitutes for 1 year of experience.
- Education: High School diploma or GED
- Special skills: Professional demeanor, excellent customer service skills, ability to multi-task, critical thinking, demonstrated computer literacy, ability to learn and demonstrate proficiency in Epic during the introductory period.
- Advanced clerical and computer skills, critical thinking skills, ability to work in high-stress situations, professional appearance and behavior, good communication skills, dependability, flexibility, teamwork.
- We request someone who is willing to be flexible to our needs from a staffing perspective.
Qualifications for Internal Candidates
Experience: 1-year relevant experience (registration, patient scheduling, customer service, billing, coding, finance, or accounting) in the healthcare industry.
License/Cert: Related certification: (Certified Coder, Certified Medical Assistant, or Certified Healthcare Access Associate) or bachelor's degree substitutes for 1 year of experience.
Education: High School diploma or equivalent.
Special Skills: Advanced clerical and computer skills, critical thinking skills, ability to work in high-stress situations, professional appearance and behavior, good communication skills, dependability, flexibility, teamwork.
Responsibilities
- Registration
- Effectively meets customer needs, builds productive customer relationships, and takes responsibility for customer satisfaction and loyalty. Represents the Patient Access department in a professional, courteous manner at ALL times. Asks patients if they may have special needs. Calls patients by name, Greets patients in a courteous and professional manner. Prioritizes and completes registration in a consistent, courteous, professional, accurate and timely manner.
- Obtains necessary information from patient, including demographic information, insurance, guarantor, and correctly inputs it into registration software. If patient is already in the system, finds correct patient record and verifies information in the system.
- Uses critical thinking skills to evaluate each registration situation to ensure customized registration experience based on individual patient circumstances. Uses knowledge of federal and state laws (EMTALA, HIPAA, Balanced Billing Act, Participating Provider statute, HITECH law, worker's compensation regulations, victims of sexually oriented criminal offenses regulation, 2 midnight rules, ABN's, Patient status requirements, MSPs, and state regulations on notification of out-of-network status) to ensure compliant registration.
- Ensures each patient is assigned only one medical record number.
- Communicates the purpose of and obtains patient/legal guardian signatures on all necessary hospital documents such as Hospital consent forms, assignment of benefits, patient rights, etc.
- Extensively documents each encounter in account notes to ensure successful cross-function communication.
- Ensures orders are received and are consistent with tests/procedures.
- Monitors the waiting room, facilitates patient flow, and resolves issues regarding orders or missing/conflicting information, to ensure timely and accurate patient registration.
- Insurance and Benefits Knowledge
- Demonstrates knowledge of insurance plans, including understanding of varying payer rules and requirements related to insurance coverage and prior authorization.
- Verifies eligibility (utilizing online eligibility software tools whenever possible) and obtains necessary authorizations for services rendered.
- Selects correct insurance plans in the registration software, in the correct order (primary versus secondary).
- Has understanding of required forms (including Medicare Secondary Payer Questionnaire) and has ability to explain them to the patient.
- Utilizes payment estimator software to calculate patient financial responsibility. Uses critical thinking skills to determine correct data input during the estimate process and to verify accuracy of output.
- Determines when patients may be eligible for financial assistance and directs patients to appropriate resources.
- Financial Collections
- Uses proven customer service techniques and scripting to collect the patient financial obligation, at or before the time of service. Negotiates with patient to ensure a deposit is collected, in accordance with corporate policy and procedure.
- Understands and explains the details of the out-of-pocket calculation.
- Analyzes documentation/notes on current and previous accounts in order to explain balances to the patient.
- Demonstrates knowledge and ability to complete account acknowledgement forms when appropriate.
- Collects cash, prints receipts, and balances cash drawers.
- Other Duties as Assigned
- Performs all other duties as assigned.
Qualifications
Experience: 1-year relevant experience (registration, patient scheduling, customer service, billing, coding, finance, or accounting) in the healthcare industry.
License/Cert: Related certification: (Certified Coder, Certified Medical Assistant, or Certified Healthcare Access Associate) or bachelor's degree substitutes for 1 year of experience.
Education: High School diploma or equivalent.
Special Skills: Advanced clerical and computer skills, critical thinking skills, ability to work in high-stress situations, professional appearance and behavior, good communication skills, dependability, flexibility, teamwork.
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