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Patient Access Representative

2 months ago

Covington, United States Avala Full time
Summary

Under thesupervision of the Director, Financial Services, the Patient AccessRepresentative is responsible for obtaining accurate patient demographics andinsurance information during the patient interview process; the processincludes in-person, and phone interviews, corrects information as needed.Processes the registration including obtaining the patients signature on theAuthorization for Treatment, Advanced Beneficiary Notice (ABN) and completingthe Medicare Secondary Payer (MSP) questionnaire. Scans all necessarydocumentation into Patient Account. Performs verification of benefits and fullyunderstands plan benefits. Collects co-payments, estimated co-insurance anddeductibles, which includes phone calls to physician offices to discussfinancial authorization status prior to service as well as collecting at timeof service. Answers incoming phone calls and assist caller as needed. And anyother duties assigned by the Director, Revenue Cycle.

Essential Duties and Responsibilities

Registration andVerification
  • Ableto handle heavy phone volumes, ensures that callers are transferred to theappropriate department and/or person. Answers calls in a timely manner;identifies department and self when answering the telephone. Able to handle allcodes and stat calls proficiently.
  • Verifiesthat patient demographic information is accurate and ensures that insurancecards, consents and other admission documents are complete and in order.
  • Abilityto explain required forms to the patient in detail (i.e.: Authorization forTreatment, Advanced Beneficiary Notice (ABN), and Medicare Secondary Payer(MSP) questionnaire). Obtains required signatures as needed.
  • Aspart of the pre-registration process, contacts patient to verify demographicinformation, insurance information, and MSP questionnaire.
  • Abilityto verify insurance coverage and understand benefit requirements and ensuresthat all notification/authorizations are completed based on plan requirements.
  • Workwith physician offices to obtain necessary authorization on scheduledprocedures.
  • Abilityto explain insurance benefits to patient.
  • Informspatients of estimated balance due based on plan benefits and collects moniesdue at time of service.
  • Demonstratesknowledge of all features and functions of the Patient Accounting areas.
  • Notifiesappropriate staff regarding any issues or concerns in a timely manner.
  • Balancesdaily receipts list to cash, checks, and credit card payments received at theend of each day.
  • Communicateswith management/physician offices regarding any problematic insurance concernsthat may affect the payment of services.
Other Duties
  • Functionsas back up to concierge.
  • Otherduties as assigned.
Core Competencies

ActionOrientation - Targets and achieves results, overcomes obstacles, acceptsresponsibility, establishes standards and responsibilities, creates aresults-oriented environment, and follows through on actions.

Communications- Communicates well both verbally and in writing. Effectively conveys andshares information and ideas with others. Listens carefully and understandsvarious viewpoints. Presents ideas clearly and concisely and understandsrelevant detail in presented information.

Creativity/Innovation- Generates novel ideas and develops or improves existing and new systems thatchallenge the status quo, takes risks, and encourages innovation.

CriticalJudgment - Possesses the ability to define issues and focus on achievingworkable solutions. Consistently does the right thing by performing withreliability.

CustomerOrientation - Listens to customers, builds customer confidence, increasescustomer satisfaction, ensures commitments are met, sets appropriate customerexpectations, and responds to customer needs.

InterpersonalSkills - Effectively and productively engages with others and establishestrust, credibility, and confidence with others.

Leadership- Motivates, empowers, inspires, collaborates with, and encourages others.Builds consensus when appropriate. Focuses team members on common goals.

Teamwork- Knows when and how to attract, develop, reward, and utilize teams to optimizeresults. Acts to build trust, inspire enthusiasm, encourage others, and helpresolve conflicts and develop consensus in creating high-performance teams.

Professional Requirements
  • Meets dress code standards and adheres topolicies.
  • Completes annual education requirements.
  • Maintains regulatory requirements.
  • Maintains patient confidentiality at all times.
  • Reports to work on time and as scheduled,completes work within designated time.
  • Wears identification while on duty, usescomputerized punch time system correctly.
  • Completes in-services and returns in a timelyfashion.
  • Attends annual review and departmentin-services, as scheduled.
  • Attends staff meetings or reads and returns allmonthly staff meeting minutes.
  • Represents the organization in a positive andprofessional manner.
  • Actively participates in performance improvementand continuous quality improvement (CQI) activities.
  • Complies with all organizational policiesregarding ethical business practices.
  • Communicates the mission, ethics and goals ofthe hospital, as well as the focus statement of the department.
  • Assists other staff members in performing anyduty that enhances the delivery of patient care.
Regulatory Requirements
  • High school diploma.
  • Two (2) or more years' experience.
Skills
  • Ability to communicate effectively in English,both verbally and in writing.
  • Basiccomputer knowledge.

Physical Demands

The physicaldemands described here are representative of those that must be met by anemployee to successfully perform the essential functions of this job. Whileperforming the duties of this job, the employee is regularly required to talkand hear. This position is very active and requires repetitive motions, standing,walking, bending, kneeling and stooping all day. The employee must frequentlylift or move items weighing up to 20 pounds.