Job Purpose
The Senior Patient Access Representative will greet, schedule, meet and register patients in a friendly, courteous, and professional manner.
Duties and Responsibilities
- Answers and routes telephone calls and messages
- Coordinates insurance verifications and pre-authorizations
- Maintains medical records and prepares charts/paperwork
- Works effectively with insurance companies to obtain/verify pre-certification/ authorization for services
- Ability to understand/interpret documented clinical information and relay pertinent medical/clinical information to the insurance company
- Faxes pre-certification request form to insurance company
- Maintains files and security of confidential information utilizing host system to scan and input data as per established procedures
- Verifies medical insurance information and documents in scheduling/registration modules
- Accurately enters and updates patient data, and other general data, into the computer system
- Patient intake; insurance verification, notification of copays/patient liability and confirmation of demographics
- Maintain account work progress, including but not limited to updating authorization logs, account referral in EMR, authorization paperwork and issue reports
- Demonstrates knowledge of varied managed care insurance and regulatory guidelines
- Monitors waiting area and communicates with clinical staff of patient readiness
- Provides assistance as needed to physicians, Department Managers, and clinical staff
- Performs other duties as assigned
- Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Qualifications
- High School Diploma or equivalent required
- College degree preferred
- 1 Year Office/Clerical experience in Healthcare field required
- Exemplary customer service skills, including the ability to negotiate and problem-solve
- Ability to communicate using clear and well organized oral and written techniques
- Strong Attention to detail
- Ability to work within deadlines with frequent interruptions
Working Conditions
- Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear. Perform light lifting (up to 15 pounds).
- Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
- Work Environment: Works in a well-lighted/ventilated office setting. Subject to frequent interruptions. Minimal occupational exposure to infectious diseases, blood borne pathogens, hazardous chemicals, noxious odors, latex, or musculoskeletal injuries. Operate Office machines properly and in accordance with Hospital safety standards. Ability to work in accordance with Hospital Safety Standards.
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Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.