Patient Access Representative

Purpose of Position

To obtain accurate and complete patient information and payer verification in a Customer focused manner, to assure expedient care and accurate billing

Description

• Interview patient and / or patient representative to obtain required information necessary to complete the registration process in the hospital information system and maintains the accuracy, confidentiality and integrity of the automated database.
• Coordinate and communicate accurate and updated registration / admission / and pre-admission activities with Medical Records, Care / Case Management, Utilization Management, Physicians' offices, Patient accounts, and any other hospital departments, as may be required, to support the appropriate, accurate, safe and effective patient care.
• Initiate and maintain organized files and records, related to orders, payer authorizations, booking slips, schedules, and others per department procedure.
• Contacts patients, employers, insurers and patient representatives to obtain insurance and other information necessary to secure hospital reimbursement, verifies benefits and pre-certifies all insurance plans to ensure maximum reimbursement to the hospital.
• Verifies benefits, utilizing insurance verification systems. Obtains referrals and authorizations required and documents complete information, along with approved bed status, if applicable, in the computer system.

Obtains pre-certifications in a manner to ensure maximum allowable reimbursement to the hospital.

• Maintains a thorough knowledge of departmental policies and procedures to ensure maximum reimbursement to the hospital.
• Attends departmental and other meetings as requested by the immediate supervisor.
• Ensure timely placement of patients in the most effective and appropriate manner. Process admissions, discharges and transfers of all Hospital patients, per department procedures.
• Explain and process payments from patients, which may include but not limited to co-pays, co-insurance, and deductibles
• Follows department procedures related to securing payment information and providing patient receipts.
• Provide information to patient and / or representative on : Health Care Proxy, Advanced Beneficiary Notice, Important Medicare Message (IMM) forms, Financial issues and refers to Financial Counselor if appropriate.

Obtain completed forms as available.

• Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers.
• Perform other work related duties and activities as assigned or requested by manager / supervisor.

Qualifications

• Ability to read, write and communicate in English at the level of a high school graduate.
• Ability to type at the rate of 25 WPM as demonstrated by a timed test.
• Computer skills to perform the job functions in a satisfactory, accurate and productive manner.
• Successful passage of a Medical Terminology course or successful passage of Medical Terminology challenge exam.
• Ability to work independently and under pressure.
30+ days ago