Patient Access Representative

Job Title

Patient Access Rep II

Job Description

Responsibilities:

• Assist in the coordination, prioritization and completion of front-end patient registration activities ranging from pre-registration through discharge in the Patient Access Services Department.
• Ensure patient insurance verification is accomplished and all requirements are met.
• Accurately completes patient registrations based on departmental protocols and standards, policies and procedures, and compliance with regulatory agencies.
• Calls patients to pre-register or confirm appointments.
• Prioritizes work for optimal reimbursement and to avoid financial risk to both patient and hospital.
• Ensures all insurance requirements are met prior to or on the date of service and informs patients of their financial liability and collects liability due.
• Identifies patients who require early financial counseling intervention.
• Ensures all uninsured patients are referred to a financial counselor as appropriate.
• Assist patients, guarantors and families with insurance questions in a professional manner and is responsible for escalating any unaddressed insurance benefit concerns to the department Financial Counselor.
• Maintains confidentiality of patient information, employee information and other information covered by regulations or professional ethics.
• Performs duties in support of the EHC Patient Access Mission Statement.
• Position requires self-motivated individual with demonstrated ability in time management who can handle high patient volumes and fast pace.
• Maintains thorough understanding of insurance, registration, scheduling, referrals, authorizations, and account follow-up.
• Maintains knowledge of multiple department system applications utilized by Patient Access.
• Familiar with and adheres to all state and federal regulations such as EMTALA, CMS, HIPAA, and JCAHO guidelines.
• Effectively communicates identified issues and concerns in a constructive and professional manner.
• Participates in generating ideas and solutions for improvements.
• Responds in a timely and appropriate way to verbal and written requests.
• Accurately searches the database to establish if patient is new or an established patient.
• Obtains required signature for release of information in a timely manner, adhering to policy and procedures.
• Completes registration by verification of information and insurance for established patient or entering information for new patient prior to discharge of patient.
• Reconfirms date of birth and legal spelling of the patients name.
• Obtains appropriate signature(s) and scans all appropriate documents (Admission/Registration Agreement, Notice of Privacy Practice, and Important Message from Medicare, etc.).
• Scans patient id and insurance cards.
• Makes every attempt to collect patient liability as appropriate and documents the response if not collected.
• Appropriately distributes registration paperwork according to departmental procedures.
• Schedules procedures/follow-up appointments.
• Communicates hospitals financial policies to all patients.
• Call patients to pre-register or confirm appointments.
• Maintains appropriate monthly assurance accuracy rate as determined by the department.
• Maintains established departmental standards regarding productivity, quality, and collections.

Minimum Qualifications

• High school diploma or equivalent.
• Must have at least 2 years healthcare related or customer service experience.
• Knowledge of Medicare, Medicaid, and other commercial payers (HMO, PPO) preferred.
• Associate or bachelor degree may be accepted in lieu of experience.
• Certified Healthcare Access Associate (CHAA) preferred.
• Typing skills with a minimum of 35 wpm and good communication skills.

Physical Requirements

Medium Max 25lbs: up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks. Environmental factors include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

Additional Details

Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare's Human Resources at View email address on click.appcast.io. Please note that one week's advance notice is preferred.