PATIENT ACCESS REPRESENTATIVE
4 weeks ago
* Greets all customers in a professional and friendly manner. Employees body language and tone are welcoming and exudes care and compassion. Quickly ascertain the reason for the visit and ensure the patient is in the correct area.
* Ensure patients receive a timely registration and typically do not exceed 15 minutes as to keep the patient flow moving thru the area, this also ensures that the clinical schedules are not affected by registration processes.
* Collects updated demographic information and accurately codes information on all patients, including but not limited to: contact numbers, emergency contact, mailing address, Living Will information, email address, marital status, Patient Type, Point of Origin, Service, Arrival By, OP Location, Visit Status, Insurance Payer, Insurance policy and group number, insurance subscriber, Physician, and occurrence Codes.
* Employee completes patient estimates using Clearance. Employee is knowledgeable of CPT and procedure codes and is able to accurately complete estimates. Is knowledgeable about insurance processing and is able to explain deductibles, co-insurance, co-payments and how processing occurs. Uses Clearance on all applicable patients and only excludes those that have Medicaid, Medicare and a secondary insurance, and those patients who qualify for full coverage under financial assistance. Employee strives to meet cash collection goals.
* Uses PCA (Compliance Advisor) for all applicable patients by entering the appropriate diagnosis and CPT codes to ensure payer coverage. Informs patients of their possible financial obligations and ensures the appropriate ABN has been signed and is scanned into the account.
* Obtains all signatures, using e-signatures, paying special attention to Medicare patients and the additional forms required. Provide a copy of the important Medicare notice to all Medicare patients. Complete MSP on all Medicare patients while also informing patient of questionnaire and the reasoning behind it. Answers all appropriate questions and ensures accurate information is entered.
* Employee obtains a copy of the patients photo ID and insurance card (if applicable and available). Documents are scanned to accounts ensuring documents are clear when saved.
* Employee creates a tickler for insurance verification of coverage and benefits on appropriate accounts as well as initiating an authorization when necessary.
* Employee is knowledgeable of the LCMH Financial Assistance program and is well versed and able to give a clear definition of the program to all customers. Employee is able to recognize when someone may need assistance and offers assistance without hesitation. Employee provides application and provides details as to what information will be needed to process a complete application.
* Employee is attentive at all times and can identify when help is needed and is able to give clear directions to all customers. If customer cannot understand employee escorts the patient to the appropriate area.
* Immediately notifies House Supervisor of all direct admissions at the time of arrival to ease some of the wait time for the patient.
* Knowledgeably discuss the online Patient Portal and explain the advantages of the system encouraging them to provide their email address. Also provides the patient with a pamphlet that lists detailed instructions on how to log into the portal.
* Assists without prompting of patient flow in their assigned area, without hesitation the employee is able to quickly analyze the area and clear up any back log.
The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.
EDUCATION AND WORK EXPERIENCE
* High school graduate or GED.
* At least one year of experience working in healthcare related field, preferably finance.
* Adequate keyboard skills (40 words per minute typing rate).
* Basic computer skills.
* Strong organizational and communication skills, including ability to discuss medical issues.
* Negotiation skills including assertiveness and being proactive.
* Ability to read, write and speak intelligible English; Ability to communicate with patients, family, peers and medical personnel; Basic math skills and appropriate phone etiquette.
* Requires emotional stability and resilience; Must be adaptable to change, be decisive, and demonstrates foresight; Exhibits organizational and leadership ability.
Physical Demands/Work Environment
* Work may require evenings, nights, weekends, holidays and/or a flexible schedule depending on the needs of the unit/department/service.
* Requires professional written and verbal communication and interpersonal skills.
* Ability to deal with stressful situations and conflict resolution.
* Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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