Patient Access Representative II
1 month ago
SHIFT: Rotating Days, Evenings, Nights, Weekends. Rotating Facilities
JOB SUMMARY
Responsible for duties in support of departmental efficiencies which may include: but not limited to performing 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 & after date of service.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
- Greeting customers following Conifer Standards of Care, provides world-class customer service, completes full patient registration at date of service, adheres to financial & cash control policies & procedures, thoroughly explains and secures Hospital & patient legal forms (i.e., Advance Directives, Conditions of services, Consent for treatment, Important Message from Medicare, EMTALA, etc.). Scan Protected Health Information, create and file patient information packets/folders for upcoming Hospital services. May also assist with scheduling diagnostic procedures (enters data in scheduling system, provide customer with appointment instructions, other tasks as needed).
- Educates patients about patient financial liabilities, employs proper, compliant patient liability collection techniques before, during & after date of service, performs Hospital cash reconciliation & secured payment entry in adherence to financial & cash control policies & procedures.
- Secures medical necessity checks/verification in accordance to Centers for Medicare & Medicaid services, verifies insurance, benefits, coverage & eligibility, completes assigned registration financial clearance work lists activities, obtains insurance authorizations for scheduled & unscheduled Hospital services, and secures 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.
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 medical facility, health insurance, or related area preferred
- Some college coursework is preferred
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 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.
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.
- 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.
Responsibilities
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
No. Description % of Time Greeting customers following Conifer Standards of Care, provides world-class customer service, completes full patient registration at date of service, adheres to financial & cash control policies & procedures, thoroughly explains and secures Hospital & patient legal forms (i.e., Advance Directives, Conditions of services, Consent for treatment, Important Message from Medicare, EMTALA, etc.). Scan Protected Health Information, create and file patient information packets/folders for upcoming Hospital services. May also assist with scheduling diagnostic procedures (enters data in scheduling system, provide customer with appointment instructions, other tasks as needed). % varies by site Educates patients about patient financial liabilities, employs proper, compliant patient liability collection techniques before, during & after date of service, performs Hospital cash reconciliation & secured payment entry in adherence to financial & cash control policies & procedures. % varies by site Secures medical necessity checks/verification in accordance to Centers for Medicare & Medicaid services, verifies insurance, benefits, coverage & eligibility, completes assigned registration financial clearance work lists activities, obtains insurance authorizations for scheduled & unscheduled Hospital services, and secures inpatient visit notification to payors. May also assist with scheduling and coordinating post discharge care for patients. % varies by site
FINANCIAL RESPONSIBILITY (Specify Revenue/Budget/Expense): N/A SUPERVISORY RESPONSIBILITIES: N/A
Qualifications
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 medical facility, health insurance, or related area preferred
- Some college coursework is preferred
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 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.
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