Shift: M-F 5:30p-9:30p
Position Goal:
The Patient Access Representative responsibilities include ER registration, PBX, payer identification and verification, and point of service collections. Vital functions include: timely, accurate and complete data gathering and entry in the computer system(s) of patient demographic and benefit information, verification of benefits eligibility and limitations, coordination of benefits, determination and collection of patient’s financial responsibility at the point of service and satisfaction of regulatory requirements. This position is vital to not only the patient satisfaction but the operations of the facility as well as the operational financial success. Essential is the ability to provide excellent customer service to patients, patients’ family members, healthcare providers, medical staff offices, and peers.
Position Responsibilities:
- Performs all elements of the patient intake process with proven accuracy by performing Master Patient Index inquiries using established identifiers to ensure non-duplication of medical records numbers. Demographic information is collected/updated in the system including emergency contact, telephone numbers, and financial information accurately. Completes record before the end of daily shift.
- Benefits are to be identified, verified by computer or telephone, coordinated and entered in the system while fulfilling Medicare requirements and completing the Medicare Secondary Payer Questionnaire accurately.
- Determines and informs patient/guarantor of financial responsibility and collects at point of service, issuing receipts as appropriate to include outstanding balances.
- Appropriately document notes on each account.
- Consistently provides explanations and information to the patient and obtains signatures as appropriate.
- Ensures all forms are completed by the patient/guarantor at the time of service to include all payer specific required forms to include but not limited to, Tricare, Veterans Administration, and United Healthcare
- Accurately scans the patient ID, insurance cards, eligibility responses, payments, receipts, authorizations, notifications, referrals, and signatures to the patient’s account.
- Maintains proficiency in the use of all systems and communication devices essential to the efficient, effective performance of Patient Access functions.
- Supports the department goals for point-of-service collections by identifying the patient responsibility, communicating to the patient or responsible party at registration their financial responsibility to include collecting co-payments in the ER.
- Knowledgeable of Current Procedure Terminology Codes (CPT), ICD-10 Codes, and medical terminology.
- Knowledgeable of health insurance, benefit eligibility, and HIPAA (Health Insurance Portability and Accountability Act).
- Knowledgeable of EMTALA (Emergency Medical Treatment and Labor Act) and adheres to the set guidelines to ensure compliance.
- Reviews charts for accuracy and completes charts before the end of daily shift.
- Knowledgeable of procedures governing the arrival of Joint Commission and other groups.
- Responsible for updating all inpatient and observation accounts based on physician orders within 30 minutes of receiving updated physician orders.
- Responds to emails before the next business day.
- Performs general clerical office duties as required in the Patient Access Office, including but not limited to filing, faxing, scanning and copying documents.
- Actively assist and engage in other areas of the department as needed in order to achieve departmental goals.
- Meets assigned departmental quality assurance, point of service collections, insurance verification, registration time and monthly percentage goals.
- Demonstrate superior prioritization, organizational, and time management skills.
- QA must be completed and all corrections made within two days of batch date.
- Can perform all Code/Alarm procedures.
- Provides excellent customer service to all patients, family members, and coworkers.
- Maintain excellent and open verbal communication with clinical staff members.
- Responsible for making sure that Supervisor has most up to date contact information.
Experience: Previous office experience in a hospital or medical office, patient access or financial services preferred. Good math skills and typing proficiency. Must have exceptional customer service skills as well as verbal and non-verbal communication skills.
Education: High school diploma or equivalent required
Special Qualifications: Ability to work independently. Ability to interact well with the public, i.e. children, adolescents, adults and geriatric. Ability to work in a fast-paced, high-stress environment. Certified Patient Accounts Representative (CPAR) or Certified Healthcare Access Associate (CHAA) preferred.
The Hughston Clinic, The Hughston Foundation, The Hughston Surgical Center, Hughston Clinic Orthopaedics, Hughston Medical, Hughston Orthopaedics Trauma, Hughston Orthopaedics Southeast and Jack Hughston Memorial Hospital participate in E-Verify. This company is an equal opportunity employer that recruits and hires qualified candidates without regard to race, religion, color, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or veteran status.