Patient Access Rep PD

Summary Under the general supervision of the Supervisor, and according to established policies and procedures, interviews and registers all patients (Inpatient and Observation, Emergency, and Outpatients) to obtain demographic, third party insurance and related financial information, and enters to on‑line computer system. Initiates, reviews and follows‑up on patient accounts to ensure proper data collection for billing. Verifies all demographic and insurance information and obtains referrals as required. Brown University Health employees are expected to successfully role‑model the organization’s values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done: Instill Trust and Value Differences, Patient and Community Focus, and Collaborate. Responsibility Greets and directs all patients, families and visitors in a prompt and courteous manner. Interviews patient or patient’s representative to obtain complete and accurate third‑party health insurance and related personal/financial information. Follows‑up on missing data by interviewing patients, families or calling employers, nursing homes and other facilities. Completes registration and enters all data obtained into the hospital computer system. Prepares or completes records, ensuring patient is properly identified per department policy and verifying demographic and insurance information by asking open‑ended questions. Registers all patients (Outpatient, ED, Inpatient and Observation) by entering and/or verifying demographic insurance information into the hospital information system and upgrades the account to an active status. Completes required documentation on financial clearance reports as indicated by the Patient Advocate or Pre‑Registration Office. Utilizes online tools and/or telephone to verify coverage, determine level of benefits, and confirm that the primary care physician (PCP) matches the PCP recorded in the hospital system. Contacts insurance carriers or companies for missing information when necessary and notifies the Pre‑Registration Office if coverage changes from pre‑admit/pre‑registration information. Identifies primary and secondary insurers, records the information in the system, and completes lien forms when a liability exists. Ingests financial notes and gathers paper referrals from patients when required by the payer. Consults the Financial Counselor/Pre‑Registration Office if insurance does not verify or if the patient lacks a required referral. Utilizes the system to determine self‑pay balances for all patients, using reference tools to estimate the expected payment due at the time of service. Refs patients to the Patient Financial Advocate for complex cases and collects co‑payments as required by policy. Documents collections in the system, logs payments and provides receipts per department policy. Completes financial clearance screens and explains consent, financial and insurance forms to patients. Obtains patient signatures on all required forms (e.g., Privacy Notice, Patient Agreement, Insurance‑Related messages). Creates patient bracelets per identification policy and places them on patients. Uses department scheduling and workflow reports to complete daily work and communicates with service departments for order information. Obtains authorizations required before the time of service by contacting the Patient Financial Advocate or Pre‑Registration Office. Asks patients for Advance Directives and prepares them with admission paperwork; provides Advance Beneficiary Notice (ABN) explanations and signatures. Performs medical necessity checks using the order entry system when not already done during pre‑registration. Distributes financial aid applications for patients lacking adequate insurance coverage per established criteria. Pre‑admi res, pre‑registers scheduled outpatients and inpatients, verifies demographics, and ensures referral accuracy. Obtains and verifies all other information required to secure payment through sources such as Worker's Compensation, MSP, Medicare liability, liens, etc. Establishes level of insurance benefits and expected payment for selected services, determining the patient’s portion of payment. Checks outstanding balances for previous services and contacts patients for pre‑payment as required. Coordinates with the Nursing Department to assign patient beds per case‑management guidelines. Reviews newly assigned medical record numbers for duplication and reports duplicates per protocol. Participates in staff meetings and, when required, covers multiple locations (e.g., Hospital-based Admitting, ED, Outpatient and Pre‑reg areas). Protects and preserves patient privacy, confidentiality, and the department’s equipment (e.g., fax, phone, visa machine). Performs additional related duties as required to support the operations of the Department. Minimum Qualifications High school diploma or equivalent. Knowledge of medical terminology, third‑party insurance information and standard office computer applications. Knowledge of third‑party payer verification and authorization processes preferred. Typing and data‑entry skills required. Customer‑service skills – six to twelve months of previous third‑party billing or hospital registration experience. Data‑entry and PC proficiency required. Physical & Work Environment Sitting for prolonged periods at a workstation; moderate to excessive walking may be required. Ability to lift up to 10 pounds. Employment Details Pay Range: $18.13–$29.90 Work Type: every other weekend and holidays Work Shift: Day Daily Hours: 8 hours Driving Required: No EEO Statement Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment. Location Newport Hospital – 11 Friendship Street, Newport, Rhode Island 02840 #J-18808-Ljbffr NPT Newport Hospital