Patient Access Rep

Job Details

Description

General Summary: The Patient Access Representative I provides customer service coverage for Fisher‑Titus and assumes the responsibility for successful financial outcomes of all patient services. This position performs imperative duties, including but not limited to appointment scheduling, registration, insurance verification, telephone coverage, data entry, filing protected health information (PHI), patient referrals, and point‑of‑service collections while maintaining patient relations and customer satisfaction.

Education, Licensure, Registration And Experience

• High School diploma or GED required
• Associate's degree in healthcare administration, business administration, or related field desired
• At least 3‑5 years of customer service, administrative, and/or data entry experience required
• At least 3 years of experience in a healthcare environment preferred
• Knowledge of database software applications desired
• Customer service, teamwork, and conflict resolution skills
• Efficient time management skills and ability to multi‑task
• Strong written, oral, and interpersonal communication skills
• Demonstrated skills in organization, planning, coordinating, and collaborating
• Strong understanding and comfort level with computer systems and Microsoft Office

Essential Functions

• Promptly fields and/or directs incoming calls, responds to patient/staff inquiries, and initiates patient triage slips when necessary.
• Works with patients to coordinate and accurately record appointment times and keeps a record of all scheduled, cancelled, and changed appointments to prevent over‑ or under‑booking.
• Ensures all registration and admission forms are ready for patients to complete upon arrival for service.
• Practices proficient customer service skills by greeting and treating all patients and staff with respect and discretion.
• Gathers and verifies all appropriate, confidential health and financial information from patients while using various computer software to assure payment for all authorized services.
• Enters new patient data and/or verifies patient records are up to date, confirms the completeness of the electronic medical record (EMR), makes changes as necessary, and files records in accordance with Fisher‑Titus' filing system.
• Complies with all organizational, state, and federal laws and registrations related to patient privacy and confidentiality, such as the Health Insurance Portability and Accountability Act (HIPAA).
• Verifies insurance eligibility and benefits within a timeframe determined by Fisher‑Titus and obtains pre‑authorizations from third‑party payers in accordance with payer requirements.
• Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant coverage/eligibility information to the patient.
• Identifies patients who will need Medicare Advance Beneficiary Notices (ABNs) of non‑coverage and maintains accurate record of authorizations within the electronic health record.
• Holds sufficient understanding of insurance protocols for referrals, co‑payments, and deductibles.
• Demonstrates knowledge of safety policies and procedures by maintaining a safe environment.
• Exhibits professionalism in appearance, speech, and conduct. Ensures that services are provided in accordance with state and federal regulations, as well as organizational standards.

Working Conditions

Completion of other duties as assigned, including clerical responsibilities.

• Stand/Walk - 1–2 hrs
• Sit - 4–6 hrs
• Drive - N/A
• Bend - Up to 1/3 of time
• Squat - Up to 1/3 of time
• Reach - Up to 1/3 of time
• Lift - Up to 1/3 of time
• Carry - Up to 1/3 of time
• Push - Up to 1/3 of time
• Pull - Up to 1/3 of time
• Right Hand - Fine Motor Function
• Left Hand - Fine Motor Function
• Right Foot - Gross Motor Function
• Left Foot - Gross Motor Function
• Vision- Clarity of Vision, near, mid and far
• Hearing- Hears normal conversation

Standards Of Employment

• Attends all mandatory education programs and can describe his or her responsibilities related to general safety and regulatory compliance.
• Appearance is professional, neat, clean, and appropriate for the work environment. Wears proper photo identification badge while on duty.
• Maintains confidentiality of all hospital and patient information at all times, as observed by peers and management.
• Attends monthly staff meetings and participates in monthly rounding process with manager to assure effective and timely two‑way communications.
• Participates in and completes required department specific education and training programs and can describe his or her responsibilities related to department safety and specific job‑related hazards.
• Follows safety and security policies including exposure control plans/blood borne and airborne pathogens.

Core Requirements

• Supports the mission, vision and CARES values of Fisher Titus.
• Is knowledgeable of patient rights and ensures an atmosphere which allows for the privacy, dignity and well‑being of all patients in a safe, secure environment.
• Supports, cooperates with, and implements specific procedures and programs for:
• Safety, including universal precautions and safe work practices, established fire/safety/disaster plans, risk management, and security, report and/or correct unsafe working conditions, equipment repair and maintenance needs.
• Confidentiality of all data, including patient, employee and operations data.
• Quality Assurance and compliance with all regulatory requirements.
• Compliance with current law and policy to provide a work environment free from sexual harassment and all illegal and discriminatory behavior.

Key Service Behavior

To assure our patients, family members, visitors, customers, fellow employees, vendors and our community in general are receiving the ultimate experience, we have developed the following service behaviors that are “absolutes” in how our employees are to perform in their job; Every Patient... Every Time.

• Communicates with Compassion - Every patient, Every time
• Engages in active listening skills
• Utilizes the AIDET communication tool
• Uses key words at key times
• Utilizes HEART service recovery techniques
• Demonstrates Service Etiquette - Every patient, Every time
• Smiles and greets patients using the 10/5 rule
• Demonstrates a calm, positive attitude through tone and body language
• Ensures patient privacy and promotes a healing environment
• Adjusts approach to respect the diversity of patients
• Assesses and manages patient's expectations of care
• Commitment to Safety - Every patient, Every time
• Follows established safety guidelines to reduce risk of adverse event through early recognition
• Commits to the Culture of Safety; If you see something, say something
• Delivering High Quality Care - Every patient, Every time
• Commits to efficient, effective and purposeful work and delivery of care