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Patient Access Representative ER
2 months ago
Citizens Medical Center is seeking a highly skilled Patient Access Representative to join our team. As a key member of our patient access team, you will be responsible for ensuring accurate and efficient registration of patients, while providing exceptional customer service and promoting a positive work environment.
Key Responsibilities- Obtain and enter accurate demographic and insurance information in the electronic health record (EHR) for patients presenting at various entry points of the facility.
- Employ effective communication skills to promote excellent customer service in every interaction.
- Coordinate insurance verification on all admissions to ensure coverage meets standards of admission and order criteria.
- Adhere to all departments, hospital, governmental, and/or any other healthcare licensing agency requirements related to the Emergency Medical Treatment and Labor Act (EMTALA) and the Health Insurance Portability and Accountability Act (HIPAA).
- Promote a positive work environment and contribute to a dynamic team focused work unit that actively helps one another to achieve optimal departmental and organizational results.
- Communicate openly in a non-judgmental manner and in a professional demeanor during all interactions with customers and co-workers.
- Contribute to departmental and hospital patient experience. Proactively seek solutions to address patient issues and concerns. Alert management in a timely manner to any unusual and/or difficult situations impacting the level of service.
- Consistently take the necessary steps to ensure that protected health information remains private and confidential, according to established State and Government Privacy Rule guidelines.
- Organize time effectively, minimizing incidental overtime and set priorities. Utilize time between heavy workloads efficiently and help other team members.
- Display initiative to improve job functions. Demonstrate adaptability and flexibility during changing demands. Offer suggestions to streamline process for efficient patient flow.
- Seek opportunities to expand learning beyond baseline competencies with a focus on continual development.
- Review physician's order for the appropriate CPT/diagnosis code to support authorization, precertification, and medical necessity according to specific payer guidelines.
- Obtain insurance verification and benefits using an automated verification tool, insurance carrier websites, Patient Estimator software, or by phone. Prepare an estimate for scheduled services and notify the patient/guarantor of any applicable out of pocket and request payment at time of pre-registration prior to service or the day of service.
- Pre-register patient cases by entering complete and accurate information into the hospital billing system prior to the patient's arrival. Identify and verify all essential information pertaining to intake, guarantor, subscriber, insurance verification/eligibility, and precertification on complex and specialized patient accounts.
- Coordinate with patient, referring physician's office, and/or referring location, scheduled service area, financial counselors, case management, Health Information Management, and other departments/ancillary areas as appropriate to obtain additional information or provide information on patient's' financial status or other potential payer technicalities.
- High School Diploma required. College or vocational courses/certificates with a medical focus preferred.
- Two years of experience in a strong customer service environment required. One year of registration experience in a hospital environment preferred.
- Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially regarding activities impacting patient or employee safety or security.
- Proficient computer skills and ability to learn and navigate multiple software programs.
