Patient Access Representative

Position Responsibilities Collects accurate and complete patient information (i.e., legal name, permanent/local address, phone number, next of kin, employer, guarantor, insurance information, physician, etc.) and enters it in the system within the established time frames. Verifies insurance information, including eligibility and benefits (i.e., deductibles, co-payments, out‑of‑pocket expenses, maximum lifetime coverage, exclusions/limitations/pre‑existing conditions, etc.) and obtains appropriate referrals, pre‑certifications, and/or authorizations for all patients: scheduled patients no later than 24 hours, unscheduled patients at point of service within the established time frames. Enters complete insurance verification information, which includes eligibility, benefits, etc., in the insurance verification screen and note fields. Ensures that a copy of insurance cards (front and back) and a copy of a picture ID is obtained and scanned at the time the patient appears for service. Provides and explains all registration documents (i.e., general consent forms, advance directive information, patient rights information and privacy notice information). Greets all patients when they arrive for their appointments, checks their status, announces their arrival to the therapists, and makes all transportation arrangements for patients that require assistance. Assists patients in understanding their insurance benefits and explains hospital financial and deposit policies, including upfront collections. Follows established guidelines for upfront collections and collects and disburses revenue, ensuring at all times 100% accuracy of all ledgers and receipts in accordance with established guidelines. After completion of the registration process, ensures all registration documents, as well as orders, accompany the patient to the appropriate area. Enters specific therapy‑related occurrence codes as required and maintains accuracy of codes on subsequent registrations throughout the treatment duration. Obtains patient outcome (FOTO) surveys and ensures accurate entry into the computer program by the patients and therapists. Consistently demonstrates a clear understanding of departmental needs and job functions as assigned by the department manager and/or team leader. Demonstrates full knowledge of Compliance Advisor’s functionality as it relates to Medicare compliance and accurately enters diagnosis according to prescription to check for ABN compliance. Ensures that every registration has the correct procedure (PT, OT, ST, CR), diagnosis (no R/O), printed physician’s name and address on RX/referral, and signature of doctor when indicated. Maintains compliance of patient access processes and federal, state, and local laws and regulatory standards (AHCA, HIPAA, Medicare, Medicaid, EMTALA, COBRA, etc.). Demonstrates knowledge and proper use of the scheduling program and department policies regarding cancellations and no‑shows. Demonstrates knowledge and proper use of HPF and QCI. Demonstrates knowledge and proper use of Avility Web MD and RTE applications. Demonstrates flexibility and the ability to perform multiple functions within the patient access department. Demonstrates knowledge and applies customer service strategies at all times. Qualifications License/Registration/Certification: Not applicable. Education: High school graduate or equivalent level of training. Some college preferred. Experience: One year practical experience in computer usage. One year prior experience in registration, collections and insurance verifications preferred. Excellent communication and customer service skills. Benefits Health benefits Life insurance Long‑term disability coverage Healthcare spending accounts Retirement plan Paid time off Pet insurance Tuition reimbursement Employee assistance program Wellness program On‑site housing for select positions and more! #J-18808-Ljbffr Mount Sinai Medical Center