Patient Access Representative II - WTMG Cardiology Clinic

Patient Access Services Subject Matter Expert

This position will function as a subject matter expert for the department and will help coach and mentor less experienced staff on all aspects of Patient Access Services and the Revenue Cycle. This position is responsible for completing the financial clearance process within PAS and creating the first impression of WTH's services to patients and families and other external customers. Responsible for obtaining, coordination, and directing information from patients, physician offices, hospital departments, and clinics in order to schedule patient appointments. PAS reps may also be responsible for scheduling patients.

Essential Job Functions

• Ensures that proper insurance payer plan choice and billing address are assigned in the automated patient accounting system.
• Financial Clearance - Contacts payers to verify insurance eligibility.
• Refers to the designated area if medical necessity fails or if referrals / authorizations are denied.
• Pre-Service / Point of Service Collection - Interprets third-party payer policies to establish patient financial liabilities and work with patients so they understand their patient financial responsibilities.
• Collect co-payments, co-insurance, and deductibles according to pre-service / point of service collections policies and procedures.
• Communication & Miscellaneous - Advises next-level leader of possible postponement or deferrals of any elective / non-emergent admission which has not been approved prior to service date.
• Maintains accurate files for pre-processing information as required.
• Demonstrates excellent communication skills and the ability to work with all levels of staff to resolve urgent issues in a prompt and professional manner.
• Investigate, resolve, and document patient problems and contact medical staff, nursing staff, ancillary departments, and administration as necessary.
• Assists with cross-training function in areas within Patient Access Services.
• Performs related responsibilities as required or directed.

Job Specifications

Knowledge, Skills, and Abilities

Nondiscrimination Notice Statement : We are 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.