Patient Access Representative

1 month ago

Oak Park, United States West Suburban Medical Center Full time

Why Us

For over 100 years, West Suburban Medical Center has supported generations of families in the Oak Park and surrounding areas. Our kind, caring hospital staff have a passion to heal and make a difference in our community. We understand that our employees are the heart of our facility. If you are looking for a family atmosphere, a company committed to professional growth and a culture that embraces our five core values of Quality. Innovation. Service. Integrity. Transparency.

JOB SUMMARY Under general supervision, provides quality service registration for inpatient and outpatient encounters. Accurately collects, analyzes and records demographic, insurance/financial, and clinical data from multiple sources, and obtains other information and signatures necessary for scheduling, registration, and billing. Effectively screens for compliance with payer requirements for medical necessity and pre-certification and completes third-party eligibility and benefit verification to ensure accurate payment is secured. Interacts in a customer-focused and compassionate manner to ensure patients and their representatives’ needs are met, and that they understand the hospital’s revenue cycle expectations, including resolution of personal liabilities through various payment options.

JOB QUALIFICATIONS

High School diploma.

Two years of admitting experience.

Medical terminology preferred.

Must speak and write English.

JOB DUTIES

Demonstrates the WSMC Customer Service Values, which are key in providing quality service to patients and customers.

Registers patients in a timely, accurate, efficient manner. Identifies chief complaint or diagnosis. Determines correct demographic, financial, and insurance information

Collects the patient liability for each visit, decides for payment according to policy, or refers the patient to the proper person to arrange payment.

Contacts physician’s office or ancillary area to clarify diagnosis, symptom, nature, or sequence of ordered services

Enters charges, breaks down and distribute charts, completes, and discharges patients through the system.

Registers and routes patients to physicians’ offices, and answers telephones.

Reviews reports as assigned and makes appropriate corrections in system.

Reviews physician orders and other documentation against payer coverage and medical necessity criteria; uses screening software to determine whether services being provided meet third-party requirements for payment; contacts physicians as necessary for additional clinical information; informs physicians about payer requirements; initiates the Medical Advance Beneficiary Notice as appropriate; and explains payer policies to patient.

Interprets physician orders for service, uses appropriate accommodation and service codes, and establishes account parameters to ensure revenue is properly recorded and accurate bills are produced.

Assists with transportation of patients within the hospital.

Accurately collects and analyzes all required demographics, insurance/financial, and clinical data necessary to schedule, pre-register, and register patients from all payer classes. Interacts with patients, their representatives, physician office staff, employers, and others, and reviews new and previously recorded information.

Follows EMTALA, HIPAA, payer, and other applicable regulations and standards for registration.

Appropriately explains, secures, and witnesses all signatures required to provide medical treatment, assign insurance benefits, release information, establish financial responsibility, and meet other internal, regulatory, or payer requirements. Completes the Medicare Secondary Payer (MSP) questionnaire when applicable. Accurately prepares required forms, documents, and reports, including labels, patient ID Bands, medical record forms, death certificates, and other special documents. Produces and distributes these on a timely basis to both internal and external parties.

West Suburban Medical Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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