Patient Access Representative
3 days ago
Serves as the face to face point of contact for patients. This job is intended for use by positions employed by a hospital. Obtains all necessary information to register and financially clear patients. Greets patients/family members and obtains and/or verifies relevant information in the process of registering financially clearing patients for service delivery. Enhances the patient experience throughout all patient interactions by serving as the customer service point of contact at the point of service by demonstrating knowledge of Sutter's Health system and service offerings.
These Principal Accountabilities, Requirements and Qualifications are not exhaustive, but are merely the most descriptive of the current job. Management reserves the right to revise the job description or require that other tasks be performed when the circumstances of the job change (for example, emergencies, staff changes, workload, or technical development).
JOB ACCOUNTABILITIES:
OPERATIONS:• Greets patients/family members and obtains and/or verifies demographic, clinical, financial, and insurance information in the process of financially clearing patients for service delivery, including the entry of patient/guarantor information in the patient registration/accounting systems, collection of patient signatures on all appropriate forms and the imaging/copying of registration documents.• Utilizes inputs to authenticate and register patients for service delivery for patients who have registered through the Patient Access Center; for those who are not registered, completes the end-to-end process of registration through close-out for service delivery.• Obtains and processes signed physician orders.• Maintains assigned work queue.• Conducts insurance eligibility/benefit verification, referral/authorization, and financial education on designated accounts.• Calculates estimated patient liability, informs patient/guarantor and actively collects appropriate patient liabilities, including co-payments, deductibles, and deposits at time of service and/or processes patient payments, accepts payments on prior services.• Refers appropriate cases to financial counseling for follow-up and consultation.• Executes other duties as assigned, such as cashiering, bed management, and communications operator.• Enhances the patient experience throughout all patient interactions, which will be face-to-face or by other means of communication demonstrating knowledge of Sutter’s Health system and service offerings.
CONTINUOUS IMPROVEMENT:• Supports the implementation of programs, policies, initiatives, and tools.• Contributes ideas and actions towards the continuous improvement of Patient Access related processes within area of influence.
PEOPLE DEVELOPMENT:• Adaptable to learning new processes, concepts, and skills Seeks and responds to regular performance feedback from team lead; provides upward feedback as needed.
RELATIONSHIP MANAGEMENT:• Maintains positive work relationships with members of other teams to communicate effectively and to ensure compliance with cross-team responsibilities. Assists in ensuring efforts of the team to support building strong peer-to-peer relationships.
PATIENT SATISFACTION:• Performs revenue cycle tasks necessary to ensure compliance and exceptional customer service.• Authenticates patient identity throughout all processes.• May provide directional support to patients and/or family members.• Maintains knowledge of applicable Federal, State, and local laws and regulations, Standards of Conduct, Standards of Behavior, as well as Sutter policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.• Meet the department monthly cash goal.
EDUCATION: Equivalent experience will be accepted in lieu of the required degree or diploma's Diploma or equivalent education/experience
TYPICAL EXPERIENCE:
1 year of recent relevant experience.
SKILLS AND KNOWLEDGE:
General knowledge of patient access, financial counseling, functions in acute, and non-acute settings. Working knowledge and understanding of insurance and medical terminology. Emergency Medical Treatment and Active Labor Act (EMTALA) and Consent Laws knowledge. Time management skills and the ability to manage frequent in-person patient contacts while effective maintaining and documenting data in the patient registration systems. Demonstrated ability to work in multiple computer systems, such as patient registration/accounting systems, telephone consoles, document imaging, scanning, payment posting, proprietary payer websites and data quality monitoring, both accurately and efficiently. Possess verbal and written communication and active listening skills. Accuracy and attentiveness to detail. Decision making and problem-solving skills. Must be able to work concurrently on a variety of tasks/projects in diverse environment. Ability to meet or exceed targeted customer service, productivity and quality standards. Computer proficiency skills. Requires the ability to work with and maintain confidential information.
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