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Patient Access Coordinator

2 months ago

Camden, Tennessee, United States West Tennessee Healthcare Full time
Job Title: Patient Access Representative I

This role is responsible for ensuring seamless financial clearance processes within Patient Access Services, creating a positive first impression of West Tennessee Healthcare's services to patients and families, and external customers.

The Patient Access Representative must effectively communicate information to patients, guarantors, and family members, ensuring they understand their financial responsibilities and what to expect from our services.

This position assumes responsibility for collecting and documenting patient information, including pre-registration, registration, insurance verification, benefits verification, certification, referral management, patient liability collections, and medical necessity checks.

The Patient Access Representative will work closely with medical staff, nursing, ancillary departments, insurance payers, and external sources to assist families in obtaining healthcare and financial services.

Essential Job Functions:
  • Maintain best practice routines per department guidelines.
  • Daily work queues are maintained at acceptable levels according to department policies.
  • Correspondence is worked daily to current.
  • Registration:
    • Perform financial clearance process by interviewing patients and collecting and recording necessary information for pre-registration and registration.
    • Ensure proper insurance payer plan choice and billing address are assigned in the automated patient accounting system.
    • Verify relevant group/ID numbers.
    • Complete the registration process according to established policies and procedures.
    • Inform families with inadequate insurance coverage regarding financial assistance through government and financial assistance programs.
    • Perform initial financial screening and refer accounts for financial counseling and/or eligibility assessments.
    • Ensure all referrals and treatment authorizations for all patient types have been obtained according to outlined requirements.
    • Contact payers for approvals if not obtained.
    • Complete initial medical necessity checks.
    • Refer to designated area if medical necessity fails or if referrals/authorizations are denied.
  • Communication & Miscellaneous:
    • Advise next level leader of possible postponement or deferrals of any elective/non-emergent admission which has not been approved prior to service date.
    • Maintain accurate files for pre-processing information as required.
    • Investigate, resolve, and document patient problems in a timely and efficient manner.
Job Specifications:
  • Education: High School Graduate or equivalent.
  • Licenses, Registrations, Certifications: N/A.
  • Experience: 1-2 years of healthcare or related experience preferred.

West Tennessee Healthcare is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, disability, religion, national origin, gender, gender identity, gender expression, marital status, sexual orientation, age, protected veteran status, or any other characteristic protected by law.