Access Center Representative I

Bargaining Unit: EA

Rate of Pay: $29.17hour + DOE

Access Center tasks include:

• Scheduling
• Pre-registration
• E-verifying
• Determining and collecting the patient’s out-of-pocket expenses (co-pays, deductibles, etc)
• Signing patients up for self-service options
• Authorizations

• Schedules appointments for primary care, specialty providers and hospital services.
• Provides information to callers including directions, addresses, telephone numbers, appointment times, etc.
• Answers incoming phone calls to hospital’s main numbers, routes calls appropriately.
• Serves as the primary point of contact for patients scheduling outpatient appointments in the District; may be via telephone or electronic means.
• Educates patients on various self-service programs offered by the District (patient portal, etc.).
• Works with patients, families, providers, clinical and non-clinical staff to coordinate the patient’s experience through-out the process of accessing healthcare.
• Interviews patients to effectively schedule and register.
• Collects, verifies and updates patient demographics, guarantor information and insurance information.
• Establishes eligibility and verifies benefits.
• Determines and collects co-pays and estimated out-of-pocket expense as appropriate.
• Advises patient and families of hospital financial policies.
• Refers to financial counselor as appropriate.
• Obtains authorizations if assigned.
• Follows established parameters to ensure procedures, treatments, tests, and appointments are scheduled with the required amount of time and with the appropriate resources.
• Articulates information in a manner that patients, guarantors, and family members understand.
• Key contributor to patient satisfaction initiatives by participating in process improvement activities as well as providing a high quality contact experience for the patient with every interaction.
• Provides the patient with preparation instructions pertinent to their service.
• Communicates regularly with patients, families, care-givers, providers, clinical and non-clinical staff as necessary for the completion of authorizations.
• Contacts the insurance company and requests authorization; documents completely the interaction in the Electronic Medical Record (EMR), including person(s) spoken to, outcome and any authorization numbers.
• Follows up with providers and patients regarding denied authorizations or requests for additional information.
• Reads and interprets provider notes in order to obtain authorization.
• Confirms medical necessity of ordered procedure(s).
• Prioritizes tasks and follows work through to completion.
• Follows established parameters to ensure procedures, treatments, tests, and appointments are authorized completely.
• Navigates multiple computer applications and interprets financial and insurance information.
• Performs to department productivity and accuracy expectations.
• Maintains and updates knowledge regarding all types of insurance and healthcare coverage,
  utilizing reference materials provided.
• Demonstrates System Values in performance and behavior.
• Complies with System policies and procedures.
• Other duties as may be assigned.