Job Description

General Purpose of Job:  

The Patient Access Representative is responsible for creating a positive impression for each patient, family member, visitor, and staff member while performing the tasks of identifying patients accurately in the system, insurance verification, and collection of pre-service payment according to department policy.  The accuracy of these tasks will ensure the integrity of the organizations master patient index and secure payment for the health system for services provided.

 

Essential Duties:

This job description is intended to cover the minimum essential duties assigned on a regular basis.  Associates may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

 

• Interview patients for the purpose of collecting complete and accurate confidential demographic and financial information to comply with regulatory agencies and billing requirements.


• Schedule patient appointments, pre-registration, verification of insurance, collecting patient payments, and assigning ICD10 codes.


• Patient Access Representatives are responsible for entering timely and accurate confidential patient information in compliance with hospital policies and Federal Regulations, such as HIPAA and EMTALA.


• The Patient Access Representative will have a thorough working knowledge of health care Revenue Cycle practices.


• Provide Excellent Customer Service to patients and families for individual needs, with empathy.


• Assign appropriate ICD-10 for registration and billing compliance purposes at the point of scheduling and registration.


• Obtain signatures and information as required by regulatory agencies while in compliance with federal regulations such as HIPAA, EMTALA and Identity Theft (Red Flag) reporting.


• Verify insurance eligibility and covered benefits by using all electronic systems available to them or by phone. 


• Refer uninsured & under insured patients to FAS (Financial Assistance Specialist) for screening of assistance programs, including community, state and federal programs, in order to secure payment for the hospital.  Possess knowledge of financial class requirements with regard to registration and insurance requirements. 


• Educate the patient as to their financial responsibility. Collect prepayment for hospital services that are not covered by the patient’s insurance, including co-pays, deductibles, or good faith deposits.


• Operate multiple computer applications to register patients, schedule appointments, and retrieve surgical, testing, insurance, and financial information.


• Serve as a liaison between Patient Access and other departments e.g. Surgery Scheduling, Central Scheduling, Patient Support Services, Pre-service, Patient Financial Services, physician office staff, etc., in order to obtain required data or to escalate issues as necessary.


• Work exception accounts held internally or rejected by payers for errors related to registration.


• Cross-train to support various Patient Access areas with minimal supervision.


• Supports continuous improvements and lean initiatives implemented in Patient Access Department.


• Facilitates effective utilization of all applications used in patient access procedures by providing occasional system support and education to other Caregivers.

Job Requirements

General Requirements	• Member of National Association of Healthcare Access Management (NAHAM) - preferred • Certified CHAM or CHAA - preferred
Work Experience	• Minimum 1 year of healthcare office experience or similar setting
Education	• High School Diploma or GED or successful completion of 12 grades combined with continued enrollment in early college program
Specialized Knowledge and Skills	REQUIRED • Demonstrates excellent interpersonal and communication skills. • Maintains strict adherence to patient confidentiality. • Must pass a typing test at 35 words per minute or a data entry test successfully at 7000 keystrokes per hour. • Must successfully complete customer service skills assessment testing with 85% or greater. • Must successfully complete analytical skills assessment testing with 70% or greater. PREFERRED • Working Knowledge of EPIC, Passport, and Microsoft Outlook applications. • Working knowledge of ICD-10 coding, insurance verification, benefit interpretation, and point of service collections. • Working knowledge of Revenue Cycle process related to Patient Access, billing, pre-registration and scheduling. • Working knowledge of medical terminology