Patient Access Representative

Patient Access Representative

Purpose of Position: To obtain accurate and complete patient information and payer verification in a customer focused manner, to assure expedient care and accurate billing.

Description: Interview patient and/or patient representative to obtain required information necessary to complete the registration process in the hospital information system and maintains the accuracy, confidentiality and integrity of the automated database. Coordinate and communicate accurate and updated registration/admission/and pre-admission activities with Medical Records, Care/Case Management, Utilization Management, Physicians' offices, Patient accounts, and any other hospital departments, as may be required, to support the appropriate, accurate, safe and effective patient care. Initiate and maintain organized files and records, related to orders, payer authorizations, booking slips, schedules, and others per department procedure. Contacts patients, employers, insurers and patient representatives to obtain insurance and other information necessary to secure hospital reimbursement, verifies benefits and pre-certifies all insurance plans to ensure maximum reimbursement to the hospital. Verifies benefits, utilizing insurance verification systems. Obtains referrals and authorizations required and documents complete information, along with approved bed status, if applicable, in the computer system. Obtains pre-certifications in a manner to ensure maximum allowable reimbursement to the hospital. Maintains a thorough knowledge of departmental policies and procedures to ensure maximum reimbursement to the hospital. Attends departmental and other meetings as requested by the immediate supervisor. Ensure timely placement of patients in the most effective and appropriate manner. Process admissions, discharges and transfers of all Hospital patients, per department procedures. Explain and process payments from patients, which may include but not limited to co-pays, co-insurance, and deductibles Follows department procedures related to securing payment information and providing patient receipts. Provide information to patient and/or representative on: Health Care Proxy, Advanced Beneficiary Notice, Important Medicare Message (IMM) forms, Financial issues and refers to Financial Counselor if appropriate. Obtain completed forms as available. Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers. Perform other work related duties and activities as assigned or requested by manager/supervisor.

Qualifications: Ability to read, write and communicate in English at the level of a high school graduate. Ability to type at the rate of 25 WPM as demonstrated by a timed test. Computer skills to perform the job functions in a satisfactory, accurate and productive manner. Successful passage of a Medical Terminology course or successful passage of Medical Terminology challenge exam. Ability to work independently and under pressure.

Schedule Details: 24 Hours Per Week, Rotating Nights, 11p-7a, Every Other Weekend & Rotating Holidays

Organization: Cape Cod Hospital

Primary Location: Massachusetts-Hyannis

Department: CCH-Patient Access

Annual/Hourly: Hourly

Hiring Pay Range: $20.51-$33.69