Patient Access Rep I

Job Title

Registers patients accurately, efficiently and professionally to ensure database integrity and facilitate claims processing. Applies financial screening guidelines to ensure collectable accounts. Utilizes standards, guidelines, and written procedures for performing registration functions.

Minimum Requirements:

Education: High school diploma or equivalency.

Experience: One year experience in healthcare setting or customer service. Medical terminology and medical insurance knowledge preferred.

Knowledge and Skills: Strong customer service skills. Excellent verbal and written Communication skills. Strong interpersonal skills.

Special Training: Basic computer skills.

Mental, Behavioral and Emotional Abilities: Ability to work independently and as a team. Maintains composure in high pressure or fast-paced environment.

Usual Work Day: 8 Hours

Essential Functions

• Follows all payor requirements for both in/out of network insurance plans and identifies needs for referrals and precertification either electronically or by telephone according to department procedures and guidelines. Performs verification of benefits on all patient encounters. Audits chart for accuracy.
• Follows computer system, internet-based third-party insurance applications, department operational procedures and departmental training guidelines to obtain accurate demographic, diagnosis, authorizations/referrals and insurance information on each registration.
• Demonstrates service excellence by professionally assisting patients and customers with the utmost respect in a friendly caring manner.
• Works collaboratively with other departments, physicians and physician office staff to obtain essential registration information such as insurance authorization, referrals, diagnosis, and scripts, to secure financial reimbursement and customer/patient satisfaction
• Complies with department procedures and regulatory guidelines for Medicare Secondary Payer, Medicare Medical Necessity Regulations, Collection of co-pay, Advance Beneficiary Notice, Advance Directives, and Patients' Rights.
• Registers established goal of minimum required patients per employee shift as measured by productivity reports. Correctly identifies a patient according to policy, completes all patient registration types by collecting and entering accurate patient demographics, physician information, insurance information and valid registration specific codes.
• Obtains all necessary signatures. Assures insurance information is verified, and authorization is obtained if not done prior to service, essential registration forms are scanned into Electronic Medical Record, and chart follow up is performed as needed.
• Ascertains and records appropriately the difference between primary care physician, referring physician and attending physician.
• Displays comprehension of identifying participating CH insurance plans and ability to identify nonparticipating plans.
• Utilizes Insurance Card Database and/or Insurance Verification guidelines.
• Follows Financial Screening and Self Pay Procedure with regards to referrals for Medicaid and Charity Care.
• Attends all mandatory department meetings.
• Supports and participates in department performance improvement initiatives.
• Performs other duties as needed.

Physical Demands and Work Environment

• Frequent physical demands include: Sitting, Standing, Walking, Wrist position deviation, Pinching/fine motor activities, Keyboard use/repetitive motion
• Occasional physical demands include: Climbing (e.g., stairs or ladders), Carry objects, Push/Pull, Twisting, Bending, Reaching forward, Reaching overhead, Squat/kneel/crawl
• Continuous physical demands include: Talk or Hear
• Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.
• Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Depth Perception, Accurate Hearing
• Anticipated Occupational Exposure Risks Include the following: Bloodborne Pathogens, Airborne Communicable Disease, Extreme Noise Levels, Dust/Particulate Matter

Benefits

• Medical Plan
• Prescription drug coverage & In-House Employee Pharmacy
• Dental Plan
• Vision Plan
• Flexible Spending Account (FSA)
• Retirement Savings and Investment Plan
• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
• Disability Benefits – Long Term Disability (LTD)
• Disability Benefits – Short Term Disability (STD)
• Employee Assistance Program
• Commuter Transit
• Commuter Parking
• Supplemental Life Insurance
• Voluntary Life Spouse
• Voluntary Life Employee
• Voluntary Life Child
• Voluntary Legal Services
• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
• Voluntary Identity Theft Insurance
• Voluntary Pet Insurance
• Paid Time-Off Program