Patient Access Representative - 40 Hours, Days

Job Title

Hospital for Special Care

Scheduled Weekly Hours

40

Work Shift

First Shift

Department

Outpatient Services

We are dedicated to creating an environment of care and engagement that makes us one of the most desirable places to work, providing exceptional care to each patient each and every day!

Qualifications

• Required: High School Diploma.
• Preferred: Associate degree.
• Preferred: Knowledge of third-party insurers.
• Preferred: Two years hospital or medical business office experience, or comparable experience with third party or collection agency.
• Required: Excellent communication, organizational and interpersonal skills.
• Required: Ability to manage multiple priorities.
• Required: Familiarity with medical terminology.
• Required: Professional demeanor and appearance as well as compassionate and patient.
• Preferred: Proficiency in Microsoft Office and electronic scheduling & registration systems.

Job Summary

Responsible for the smooth operations of all front desk/reception area functions as well as other administrative/clerical duties. Pre-admission and admission of all hospital outpatients, ensuring the adequate financial backing. Responsible for accurate and timely preparation and submission of all assigned patient accounts, including charge entry. Performs ongoing analysis of accounts to determine continuation of eligibility of benefits and implements appropriate appeals, coordination of benefits, adjustments, and re-authorizations.

Physical Demands

• This position requires walking, standing, and sitting with the ability to lift/carry and push/pull up to 20 pounds frequently.
• This position also requires frequently looking at a computer and using a telephone for extended periods of time.
• This position requires the ability to bend, squat, balance, reach above shoulder height and twist frequently.
• The ability to touch, see, and hear are required continuously with gross grasp and fine manipulation.
• Frequently works in crowded, noisy environment.

Cognitive Demands

• This position requires high levels of independent judgment, problem solving, written expression / communication, verbal expression / communication, reading / auditory comprehension and computation skills.
• Adjust schedule to adapt to changing priorities.
• Use of universal precautions when necessary.
• Initiates and responds to work independently; accesses resources and can handle multiple responsibilities simultaneously.

Work Demands

• This position requires the ability to work under a variety of conditions that includes moderate noise and frequent interruptions.
• Uses Universal precautions as necessary.
• Works both independently as well as with others.
• This position requires occasional overtime on an as needed basis.

Essential Functions

• Responsible for assigned registration desk operations. Greets and receives patients and/or visitors, collects copies of insurance information, maintains all patient demographic records, and provides patient orientation regarding hospital/department policies and procedures. Clinics/recurs/admits correct account for services to be rendered. Ensure follow-up appointments are scheduled timely. Perform ongoing analysis of scheduled visits/accounts to determine continuation of eligibility of benefits. Collects co-pays as needed and balances end of day cash.
• Manage, direct and respond to incoming office correspondence as deemed appropriate, including mail, email, faxes and telephone calls and forwards queries to the appropriate staff. Utilizes office correspondence software as appropriate; Outlook, Mxie, TigerConnect. Ensures any patient related paper documents are scanned into the electronic medical record.
• Maintain solid working knowledge of insurance coverage, benefits and authorizations, Medicare Secondary Payer (MSP) questionnaire and how to log responses, Advanced Beneficiary Notices (ABN) and Memos of Understanding (MOU's). Responsible for providing estimates of Outpatient services when needed. Communicate benefit information to patients. Collaborates with outpatient authorization team when needed.
• Communicates schedule changes timely to appropriate team members. Cancels/reschedules/no shows patients with appropriate reason codes. Is familiar with coordinating schedules with various vendors and equipment when prompted by provider.
• Process incoming referrals by calling patients to make appointments within 24-48 hours, complete pre-registration, forward intake paperwork and prepare estimates. Collaborates with Team Leads, Office Coordinators and Administrative Assistants if necessary.
• Communicate hospital initiatives and policies such as Follow My Health (patient portal), Connie (statewide health information exchange), Financial Assistance and Release of Information processes to patients as requested.
• Keeps a neat and orderly workspace. Can securely open up and close up office at the start or end of business day. Is familiar with all stations within the role and can effectively cover and cross train. Participates in the training and workflow coordination of other outpatient members or support staff. Provides other regular support as designated by Outpatient Access Manager.