Patient Access Representative

Patient Access Representative

Kids Are Our Everything.

Provide patient services and administrative support in ancillary operations. Interact with parents, patients, physicians and other staff under moderate supervision in a courteous manner. Provide assistance to other employees within their department as well as other departments. Collect and verify all demographic information to ensure accuracy. May provide required notification of scheduled and unscheduled services according to insurance provider requirements. May be responsible to schedule patients for ancillary appointments. Position may be required to float to ancillary patient access areas for coverage (ED, RAD, LAB, AMSAC etc.). Next step in career ladder is Senior Patient Access Rep.

Minimum Education High School Diploma or GED (Required)Minimum Work Experience 2 years Related experience (Required)Required Skills/Knowledge Broad knowledge in administrative processes, customer service skills.Computer knowledge necessary.Microsoft Office experience preferred (Word & Excel).Complete Patient Access training curriculum and pass all competency assessments.The ability to type minimum of 35 words per minute required.

Functional Accountabilities Patient Services:

• Demonstrate accuracy of scheduling patients using the applicable scheduling system for the department. Verify applicable charge codes corresponds with diagnostic codes. Enter information into billing/registration system.
• Complete computer aided, on-line registration screen with parent/guardian via telephone or in person in professional & courteous manner.
• Collect accurate demographic and insurance information. Update systems as needed in accordance with department standards for registration accuracy. Complete bedside registration for ED patients.
• Reschedule appointment for patients who did not show or for the ancillary services cancellations by providers/technologist. Schedule follow up appointments at check out if applicable.
• Greet patients and parents courteously. Arrive patient in appropriate system based on department policy.
• Obtain required consents for department & ensure distribution of compliance related materials (i.e. HIPPA Privacy Notice, Patient Rights). Obtain copy of insurance card and photo ID to be stored in medical record (copy or scan activity required). Ensure applicable insurance company and CNMC HIM department receive copies of appropriate forms/documentation. Complete all documentation in accordance with department policy and procedure.
• Respond to patient portal work lists (i.e. appointment requests, fax queues, email requests, etc. May include messaging center work lists in the future).

Information Verification:

• Verify insurance eligibility using applicable eligibility system. Ensure managed care carve outs (lab and radiology carve outs) are adhered to.
• Advise leadership of any authorization issues at the time of check-in. Identify surgeries/diagnostic testing without an authorizations. Contact provider's office or scheduling coordinator to address issue timely without delaying patient care.
• Notify parents of the need for completed insurance referral form or pre-authorization prior to scheduled/unscheduled appointments.
• Discuss co-payment, deposits, payment in full, or past due balance collections with parents in a professional & courteous manner.
• Counsel parents or refer parent to Financial Information Center (FIC) for establishing payment schedule or method of payment.
• Verify insurance information is complete prior to procedure and collect and verify pre-authorization/referral information: goal is to obtain authorizations 5 days in advance of service.
• Utilize all systems where patient information may be stored (EPRS, SCI, Cerner, IDX, McKesson, etc.) to verify that systems are in synch.

Cash Collection:

• Collect and record co-payments, deposits and payments in full and provide payer with receipt. Responsible for helping department meet 85% of the collection target for the department.
• Maintain departmental requirements regarding cash controls and collections

Billing Preparation:

• For ancillary services ensure all applicable orders/scripts/referrals are obtained prior to services being rendered.
• Appropriately clear all walk-in and ensure scheduled/unscheduled appointments are linked to scheduling system.
• Responsible to ensure daily quality review of all registration processed real-time.

Office Support:

• Answer telephone and address caller needs appropriately. Avoid transferring calls for better service to families. Meet department standards relative to ACD policies if applicable. Manage voice mail messages within same business day.
• Distribute mail. May work returned mail as needed.
• All staff are responsible for information distributed via e-mail. Staff should check work email a minimum of 3 times daily and respond to inquiries within 24 hours (or next business day).
• Maintain office files and office supplies at P AR levels.
• Maintain clean reception area and work space.
• Other support as needed.

Benefits That Support You:

• Comprehensive health coverage, including medical, prescription, infertility, and transgender health services.
• Generous paid time off, including vacation accrual from day one, sick leave, holidays, and a personal day.
• Financial wellness support, including a 401(k) plan and healthcare and dependent care spending accounts.
• Employer-paid life, AD&D, and long-term disability coverage, with optional supplemental plans.
• Additional perks, including tuition assistance, fitness resources, employee assistance, commuter benefits, and more.

Why Join Us:

• Nationally Recognized Excellence Consistently ranked among the Top 10 Children's Hospitals in the nation by U.S. News & World Report.
• Leading Pediatric Care One of the largest and most comprehensive children's hospitals in the country, offering nationally ranked specialties and cutting-edge treatments.
• Innovation & Research A premier academic medical center with a strong commitment to pediatric research, education, and advancing the future of child health.
• Mission-Driven Culture Dedicated to providing family-centered care while fostering a collaborative, supportive environment for clinical teams.

Children's National Medical Center