Patient Access Representative

JOB SUMMARY

The Patient Access Rep performs detailed and accurate registration of all patients. Displays a broad understanding of third-party reimbursement issues. Assists ancillary departments with room assignment and transporting of patients. Works under the supervision of the Patient Access Supervisor or Administrative Director, Revenue Cycle.

ESSENTIAL FUNCTIONS

• Greets and interviews incoming patients/ relatives to obtain accurate demographic and insurance information.
• Inputs patient demographic/ billing information into computer. Obtains patient or responsible party’s signature on consents. Creates face sheets, armbands, labels, and other documents as necessary.
• Communicates to patients the details of consents, filing of insurance, and payment of hospital services. Assists patients in understanding hospital billing and collection of payment.
• Collects and scans insurance cards or completed insurance forms from patients. Obtains necessary signatures on consent form for treatment according to hospital policies and procedures.
• Obtains payment/co-payments and deposits from patients as appropriate or refers patient to Patient Accounting to make standard payment arrangements.
• Interprets Physician Orders to incorporate up to 9 Service Types and over 31 Service Locations while identifying qualifying requirements for each.
• Interprets Physician Orders to implement correct accommodation codes directly affecting patients charges and appropriate billing for services.
• Provides and incorporates accurate patient status changes directly related to ensuring patient activity/services reflect all Physician/Provider Order Entries.
• Incorporates QAS Address Verification System into each registration to confirm address legitimacy with US Postal Service.
• Incorporates Waystar Insurance Eligibility Product to validate insurance coverage with each registration.
• Initiates, audits, and supports Medicare Secondary Payer Questionnaire for all Medicare registrations to ensure compliance and requirements of reimbursement.
• Provides 24/7 Answering Service support to Community Physicians.
• Performs next day audits on all registrations, including ancillary registration areas, to ensure accuracy in registrations, promote positive reimbursement results and reduce overall AR days.
• Distributes registration records each day to appropriate departments and Referring Physicians.
• Cross trains in at least two of the four areas of Patient Access (Outpatient Registration, ER, PBX, and/or Pre-Admissions)
• Contributes to required on-call obligations to help maintain 24/7 coverage in the Emergency room Patient Access area.
• Directs patients to appropriate ancillary departments. Coordinates with nursing supervisor and/or Nursing unit to arrange proper bed assignment and transports or arranges for transport of patient to nursing unit.
• Performs receptionist duties while answering telephones, paging overhead/radio, taking messages for doctors and nurses, and contacting physicians for patients or ER Physicians.
• Provides coverage for PBX for breaks, lunches and after hours. Performs all functioning duties there during coverage times and daily after 8:30pm, including answering and directing all incoming calls, calling of all codes, accepting payments, and providing information to patients and visitors.
• Operates printer, scanner, credit card terminal and copy machine.
• Maintains confidentiality of all personnel and patient care and relations information.
• Actively participates in Strategic Quality Management for the department and organization. Actively participates in Customer/Guest Relations and Mandatory Educations programs.
• Complies with the hospital’s Corporate Compliance Program including, but not limited to, the Code of Conduct, laws and regulations, and hospital policies and procedures.
• Must be free from governmental sanctions involving health care and/or financial practices.
• Other duties as assigned. This list is non-exhaustive.

JOB QUALIFICATIONS

• Education
  • High School graduate or GED equivalent, preferred
• Experience
  • Prior medical office and/or hospital admitting experience including billing preferred.
  • Prior customer relations experience required. Prior computer, keyboarding and 10-key calculator experience required.
  • Medical terminology knowledge preferred.