Patient Access Representative II

Patient Access Representative II, Full Time Days

6:30 - 3:00 – Flexibility needed – may need to flex their schedule to an earlier start time if need be; On Call 1 weekend per month

University of Maryland St. Joseph Medical Center - 7601 Osler Drive Towson, MD 21204

Performs scheduling, registration, pre-admission processing, wayfinding, and other administrative duties in accordance with department-specific standards for data entry and patient selection. In addition to the duties of the Facility Admission Coordinator role, this position includes verification of insurance benefit eligibility, insurance pre-certification and authorization, and the creation and/or finalization of cost estimates.

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job responsibilities performed.

• Works with care teams and the revenue cycle to identify and eliminate barriers to access, reimbursement, and affordable care.
• Provides education to patients and families regarding the financial clearance process and offers information related to estimated costs of services and available financial assistance opportunities.
• Performs specific administrative and Admission, Discharge, and Transfer (ADT) functions and carries out these duties across multiple clinics and registration areas within the institution.
• Serves as the first point of contact for patients and visitors who enter the facilities and is responsible for customer service in Patient Access/Patient Administrative Services areas in a manner that ensures a customer-focused, quality-conscious work climate, recognizing that patient visits are often filled with anxiety and uncertainty.
• Primary functions include applying strong interpersonal skills, data collection, and the ability to assess situations, as well as assisting the team in developing solutions to achieve excellence in customer service while ensuring the financial viability of the hospital.
• Collects and verifies patient and insurance demographics; verifies insurance benefits and coverage by reviewing benefits information in Epic; provides cost estimates; secures pre-certifications and/or pre-notifications for patient services; collects co-pays and deposits prior to services; and provides financial assistance information to patients.
• Provides wayfinding to all clinics for which Patient Administrative Services provides registration assistance. Staff must be knowledgeable of clinic locations to safely and efficiently guide patients to their appointments.
• Maintains regulatory and functional knowledge of all required registration information to ensure timely and accurate reporting and billing; obtains all required signatures; and performs clerical duties as necessary.
• Educates patients regarding adequate insurance coverage. Understands applicable hospital and physician billing requirements and communicates proper procedures and requirements to patients.
• Communicates coverage issues to service areas and works with patients and staff to resolve them.
• Ensures accuracy and completion of paperwork prior to filing admissions. Contacts physician and clinical staff to resolve incomplete patient registration documentation and distributes admission documents as required.
• Maintains department scheduling templates for applicable providers in outpatient department locations, ensuring appropriate scheduling utilization.
• Maintains consistent contact with the Care Management and Social Work departments to ensure required information has been obtained for reimbursement and that pre-admission and pre-certification requirements are followed.
• Acts as an official training resource for departmental training of new and existing employees.
• Perform all other duties as assigned.

Work Experience Required

• High school diploma or GED.
• Two (2) years of work experience in a clerical, customer service, or receptionist position.

Preferred

• Certification and membership in local or national professional organizations such as AAHAM, NAHAM, etc., are preferred.
• Four (4) years of work experience in a clerical, customer service, or receptionist position.
• Previous experience in a healthcare setting.