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Patient Access Representative
2 months ago
Department: Patient Access
Reports to: Patient Access Manager
Grade Level: 14
Status: Non-Exempt
Job Summary:The Patient Access Representative plays a critical role in ensuring the smooth flow of patient information and registration processes. This individual will communicate with physician offices, staff, and patients to obtain demographic and insurance information for preregistration and registration. They will also ensure compliance with admission and discharge practices established by regulating agencies and third-party payers.
Key Responsibilities:- Communicate with patients and families to provide information, guidance, and assistance.
- Communicate with physician's office staff, other members of the healthcare team, and coworkers to ensure the flow of accurate and timely information.
- Perform third-party verification and payer eligibility requirements.
- Initiate service authorizations for services requested from practitioners.
- Record pertinent data for B/AR and Case Management use.
- Complete forms using medical terminology and ensure accurate documentation of patient visit complaints and admission diagnosis descriptions.
- Follow physician entry procedures, including Doctor Other, multiple locations, and address changes.
- Interview patients and/or guarantors to obtain and process accurate and complete patient information.
- Scan required patient information, insurance, and state ID cards, Advanced Directives, and other registration forms.
- Provide patients with required notices, including HIPAA, Health Care Proxy, and Patient Bill of Rights.
- Complete daily, weekly, and monthly tasks in a timely manner.
- Perform outpatient, scheduled, and pre-registered patient registrations.
- Work on multiple electronic systems to identify online orders or other patient appointments.
- Collect cash, credit card, or other forms of payments.
- Export images as needed to CDs.
- Adhere to Accounting of Disclosures for patient record requests.
- Complete all competencies for the scheduled or covered area.
- Process incoming and outgoing mail per policy and instruction.
- Respond to administrative calls and/or complaints.
- Operate the Switchboard by taking incoming calls and transferring calls.
- Maintain operator logs.
- Respond to third-party visitors.
- Perform order entry of radiologic tests.
- Follow code entry and ABN requirements per CMS guidelines.
- Review orders/requisitions and diagnosis to ensure compliance and legality of order.
- Perform electronic ordering registration procedures.
- Correctly identify patient scheduled appointments, visits, and other patient types.
- Perform downtime procedures according to policy and procedure.
- Ensure accurate registration and compliance using all resources and education provided.
- Maintain knowledge of emergency codes and safety measures.
- Maintain knowledge of direct and transferred admissions as well as outpatient registration procedures.
- Ensure all work areas are adequately stocked with supplies to provide quality services.
- Skilled in PC/CRT data entry and proficient in standard computer programs, including Microsoft Office Suite, and EMR.
- Excellent service-oriented interpersonal skills and strong active listening ability.
- Excellent written and verbal communication skills.
- Ability to productively multi-task while working with intermittent interruptions and deadlines.
- Professionalism and business acumen appropriate for working with physicians, patients, and support staff.
- Knowledge of general anatomy, medical terminology, and/or 3rd-party Insurance process preferred.
- High school diploma or GED required.
- Clerical and computer knowledge, including data entry, and ability to type 35 WPM required.
- Experience in customer service with strong communication skills required.
- 1 year experience in a customer service and/or medical office setting with knowledge of Medicare, Medicaid, and other contract payers preferred.
- Familiarity or experience with Advance Beneficiary Notice, precertification, ICD10 coding, and/or CPT codes preferred.
- Must be able to work alternate weekends and holidays with rotating shifts.
- Position requires working as needed at any of the Patient Access sites.
- Requires extended periods of sitting and using computers and standard office equipment.
- Requires use of computer software, including Meditech, Clockwise, and electronic ordering system.
- Attendance ensures that job requirements are met.
- Ability to perform light lifting (up to 15 pounds) using proper body mechanics.
- Occasionally requires assembling, using, checking, and maintaining equipment.
- Actively participates in cross-training, Quality Assessment programs, CQI, in-service programs, and mandatory classes.
- Complies with DOH requirements for annual health assessments and required immunizations.
