Patient Access Representative

Creating Life Better Here starts with you. At San Juan Regional Medical Center, we're more than a healthcare provider-we're a values-driven organization dedicated to delivering exceptional care. As a team member, you help fulfill our mission to make life better here for our community.

The Patient Access Representative inspires trust in and offers comfort to patients and families while facilitating access to medical care through the timely and accurate registration of all patients. Collaborates and communicates with physicians and care departments to facilitate patient flow and personalize the patient experience.

Required Behaviors:

• As you go about fulfilling this mission, your work habits and work relationships should embody SJRMC's values. These values are our culture, our identity as an organization: Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability and Creative Vitality ask more of us than merely completing some list of tasks. Our values ask for a deeper level of commitment, and what is asked of us we freely give because we believe in our mission.

Required Qualifications :

• High school diploma or equivalent
• Keyboard skills, accurately typing of thirty-five (35) words per minute
• Ability to operate a computer and other office equipment (copy machines, scanners, fax machines, etc.)
• Prior experience in data entry and the ability to enter information accurately into computer
• Effective verbal and written communication skills and the ability to present the information clearly and professionally
• Ability to set priorities in dealing with multiple demands and interruptions
• Ability to obtain necessary personal and financial information from patients who are ill and/or under stress
• Ability to work effectively with a team of varying personalities and cultures
• Excellent customer service skills
• Willingness to ask patients for co-payments and deposits, as appropriate
• Flexibility in schedule to accommodate the needs of the patients and the department
• Skills to effectively present information and respond to questions from patients and customers, with proficiency
• Skills to solve practical problems and deal with high stress situations while maintaining a high quality of professionalism
• Organizational, time management and resolution skills
• Ability to work collaboratively with other departments

Preferred Qualifications :

• Some post high school education
• Knowledge of medical terminology
• Knowledge of third-party payers, billing requirements, and reimbursement methods
• Prior experience in working in patient registration or a related healthcare field
• Advanced keyboard and computer skills
• Ability to communicate effectively in a second language such as Navajo or Spanish
• CHAA certified

Duties and Responsibilities :

• Accurately obtain, input, scan, and distribute all necessary information related to a patient's registration for inpatient, emergency, and outpatient services, to create and maintain an accurate medical record for the purpose of treatment and billing.
• Assign accurate MRNs, complete medical necessity and compliance checks for physicians.
• Ensure all scheduled patients are pre-registered and pre-register other patients when possible. The department goal for pre-registrations as a percentage of scheduled patients is 95%.
• Responsible for providing accurate good faith estimates to self-pay patients within established time limits.
• Responsible for providing accurate estimates for insured patients of amounts likely due after insurance pays.
• Work closely with physician offices to obtain prior authorizations prior to the patients scheduled appointment.
• Verify the accuracy of information on all pre-registered patients upon arrival and make appropriate corrections to the system as necessary to maintain accurate records.
• Ensure timely access to care by responding promptly to registration requests received by phone, fax or in person.
• Verify eligibility at the time of pre-registration or registration according to policy. Department goal is to verify 100% of inpatients, emergency room and DSU patients and 100% of outpatients with certain insurances.
• Follow managed care procedures, as applicable, to obtain authorizations for services to ensure timely payment and minimize denials.
• Clearly explain all required forms to patients and obtain their signatures.
• Explain and distribute patient education documents, such as Important Message from Medicare, Patient Rights and Notice of Privacy Practice.
• Provide excellent customer service by appropriately greeting patients and responding to inquiries from patients, visitors, physicians, and vendors and directing patients, vendors, and visitors to their destinations.
• Maintain an acceptable level of registration accuracy as defined by the department's Quality Assurance goals.
• Go to patient rooms to complete patient registrations and obtain signatures on all required forms for direct admissions and/or when a form is missing.
• Maintain all department logs, reports, and records.
• Operate the telephone switchboard to relay incoming, outgoing, inter-office and code calls, as applicable.
• Attend monthly department meetings, in-service training, and other meetings as required to maintain professional growth and/or comply with hospital policy.
• Each employee is responsible for implementing SJRMC's Service Standards into their daily work:

Safety, Courtesy, Effectiveness, and Stewardship

• Other duties as assigned

Physical Demands, Environmental Work Conditions, and Sensory Requirements:

• Must be able to walk, sit, and stand for long periods of time
• Ability to withstand frequent exposure to ill patients
• May need to work alongside caregivers in unpleasant or stressful situations, such as emergency conditions of patients, angry or upset families involved in death and/or graphic injuries
• Vision and hearing acuity within normal range