Patient Access Representative
2 months ago
Fisher-Titus Health proudly serves the greater Huron County area by providing a full continuum of health and wellness care.
Job SummaryThe Patient Access Representative provides customer-service coverage for Fisher-Titus Health, ensuring successful financial outcomes for all patient services.
Key Responsibilities- Promptly fields and/or directs incoming calls, responds to patient and/or staff inquiries, and initiates patient triage slips when necessary.
- Ensures all registration and admission forms are ready for patients to complete upon arrival for service.
- Practices proficient customer-service skills by greeting and treating all patients and staff with respect and discretion.
- Gathers and verifies all appropriate, confidential health and financial information from patients while using various computer software to assure payment for all authorized services.
- Enters new patient data and/or verifies patient records are up-to-date, confirms the completeness of the electronic medical record (EMR), makes changes as necessary, and files records in accordance with Fisher-Titus's filing system.
- Complies with all organizational, state, and federal laws and registrations related to patient privacy and confidentiality, such as the Health Insurance Portability and Accountability Act (HIPPA).
- Verifies insurance eligibility and benefits within a timeframe determined by Fisher-Titus, and obtains pre-authorizations from third-party payers in accordance with payer requirements.
- Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant coverage/eligibility information to the patient.
- Identifies patients who will need Medicare Advance Beneficiary Notices (ABNs) of non-coverage and maintains accurate records of authorizations within the [EHR].
- Holds sufficient understanding of insurance protocols for referrals, co-payments, deductibles, and performs other clerical duties as assigned.
- Demonstrates knowledge of safety policies and procedures by maintaining a safe environment.
- Exhibits professionalism in appearance, speech, and conduct, and ensures that services are provided in accordance with state and federal regulations, as well as organizational standards.
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