Senior Patient Access Representative

2 days ago

Gilbert, Arizona, United States Optum Full time
Optum Patient Access Lead Job Description

At Optum, we're dedicated to delivering care and improving health outcomes for millions of people worldwide. As a Patient Access Lead, you'll play a critical role in connecting patients with the care and resources they need to thrive.

Key Responsibilities:
  • Maintain up-to-date knowledge of registration requirements for various areas, including main admitting, OP registration, ED registration, maternity, and rehabilitation units.
  • Ensure accurate and timely entry of demographic information into the ADT system.
  • Properly identify patients to prevent medical record number duplication.
  • Review assigned accounts for accuracy and completeness, and obtain required documentation.
  • Meet CMS billing requirements for MSP, Important Message from Medicare, and Observation Notice.
  • Collect and enter required data into the ADT system, emphasizing accuracy and demographic information for reimbursement.
  • Verify patient information and correct errors at registration.
  • Obtain patient signatures for required forms and documents.
  • Scan documents into the appropriate system.
  • Provide printed materials to patients, including Patient Rights and Responsibilities, HIPAA Privacy Act notification, and Advance Directive.
  • Follow downtime procedures for manual patient information entry.
  • Assess self-pay patients for presumptive eligibility and initiate the process when necessary.
  • Monitor and address tasks associated with the Mede/Analytics PAI tool.
  • Verify insurance benefits using electronic verification systems or contacting payers directly.
  • Document insurance verification information in the ADT system, including deductibles, copayments, coinsurance, and policy limitations.
  • Obtain referral, authorization, and pre-certification information, and submit notices of admission when necessary.
  • Verify medical necessity checks for outpatient services and complete them when necessary.
  • Identify payer requirements for medical necessity and verify patient liabilities.
  • Calculate patient payments and request payment at registration.
  • Set up payment plans for patients who cannot pay their entire current copayment and/or past balance in one payment.
  • Document conversations with patients regarding financial liabilities and agreements to pay.
  • Apply payments to patient accounts and provide receipts.
  • Clarify division of financial responsibility between medical groups and insurance companies, and document this information in the ADT system.
Requirements:
  • High School Diploma/GED (or higher)
  • 2+ years of experience analyzing and solving complex customer problems
  • 1+ years of Patient Access and/or Patient Registration experience
  • Ability to work 100% onsite at 350 W. Thomas Road in Phoenix, AZ
  • Must be 18 years of age or older
  • Ability to work Monday to Friday 2pm to 10:30pm, depending on business needs
Preferred Qualifications:
  • 1+ years of experience with prior authorizations
  • 1+ years of team lead experience in patient access
  • Experience with Microsoft Office products
  • Working knowledge of medical terminology
  • Understanding of insurance policies and procedures
  • Ability to perform basic mathematics for financial payments
  • Experience in requesting and processing financial payments
  • Experience in insurance reimbursement and financial verification
Soft Skills:
  • Strong interpersonal, communication, and customer service skills
Physical and Work Environment:

Standing for long periods of time (10 to 12 hours) while using a workstation on wheels and phone/headset.

At Optum, we're committed to creating a healthier atmosphere by embracing diversity and promoting inclusion. We're an Equal Employment Opportunity/Affirmative Action employer and welcome applicants from all backgrounds.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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