Patient Access Rep (EGH)

Overview Responsibilities Admit and register patients for services in a professional and courteous manner following Beacon policies and procedures. Complete pre-registration, registration, and insurance verification; decipher eligibility responses and relay information to the patient. Document processes involving communication with patients and insurance companies. Collect applicable co-payments and deductibles; obtain insurance information from the patient. Verify insurance benefits, post applicable co-payments and deductibles, and perform daily cash balancing procedures. Obtain all required signatures on paperwork and perform clerical duties as necessary. Mission, Values, and Service Goals MISSION: We deliver outstanding care, inspire health, and connect with heart. VALUES: Trust. Respect. Integrity. Compassion. SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team. Registration/Pre-Registration/Patient Check In Incorporate add-on procedures efficiently and timely. Enter patient name, arrival time, appointment time, procedure and pertinent information into the Pager system to track patient location for daily statistical data related to patient waiting times. Identify pre-registered and non pre-registered patients with appointments using PHS and daily schedules. Verify patient demographics in PHS; print/review check-in itinerary for alerts; review orders for completeness; check in pre-registered patients accurately and quickly. Pre-register and identify the next scheduled patient to call using the electronic call list; mark pre-registration as complete or enter a time to call back. At registration, obtain identification, demographic and insurance information; ensure correct patient type, medical service, procedure and accommodation codes are entered into the hospital registration system. Verify and update information as appropriate; identify pre-registered patients for specific departments and complete pre-registration packets. Request copies of insurance cards and government ID to confirm insurance and identification. Verify patient’s insurance eligibility and obtain coverage information from the R1 insurance verification tool; ensure correct insurance plan is entered into STAR Navigator. Identify co-pays, co-insurance, and/or patient deductibles in the R1 tool; enter correct procedure and read notes regarding partial payments. Generate a receipt of payment once determined and enter payment information into the R1 tool. Check Medicare Medical Necessity software prior to ordering outpatient testing and produce an ABN when appropriate. Complete the Medicare Secondary Payer Questionnaire to meet Medicare compliance guidelines. Provide the Important Message from Medicare form for inpatients insured by Medicare or a Medicare Replacement policy. Provide the Medicare Outpatient Observation Notice for observation admissions insured by Medicare or a Medicare Replacement policy. Print orders from Care Ready as needed. Review physician orders for completeness to meet HIM guidelines and place orders for outpatient services in a timely manner. Assist patients in obtaining an order when not sent or requesting a complete order when needed. Document that privacy notices are given to ensure HIPAA compliance; protect patient confidentiality when handling orders and check-in documents. Obtain signatures for hospital consent to treat, privacy notices and other necessary forms. Scan signature pages, insurance cards, photo IDs and orders into the electronic patient folder for access and protection from identity theft. Use two identifiers to accurately identify the patient before placing the hospital patient identification band on the patient. Bed Control Answer incoming phone calls cheerfully and direct callers to the appropriate area or provide information. Routinely check bed control inbox and update patient type changes promptly. Convert pre-registered packets to the correct patient type at midnight on the day of the procedure; print and finalize documents for easy check-in on arrival. Use established guidelines to manage bed transfers and maintain a daily admissions listing. Maintain a daily calendar of planned admissions and special accommodation requirements. Update attending physicians for the hospitalist program accurately and timely as requested. Order Management Print reports from PHS for next-day scheduled outpatient procedures and produce copies of orders from Care Ready or Cerner. Complete orders in Care Ready to preserve file integrity and prevent wrong tests. Check PHS schedule to ensure orders are received for all next-day procedures and request any missing orders from physician practices. Maintain orders alphabetically for easy retrieval at check-in. Process reports from PHS to identify cancellations, no-shows, and rescheduled exams; keep scheduling information updated and process cancelled pre-registered accounts promptly. Fax requests for new standing orders before expiration date. Field all incoming calls from the front desk to troubleshoot order- and patient-related issues. Team Leader Help implement department policies and procedures and changes as needed. Act as a positive role model during training; provide constructive feedback to aid learning. Mentor staff to ensure success, especially new team members. Set clear expectations and demonstrate strong leadership. Know all department positions and cover open roles when needed; coordinate staffing to meet volume and minimize overtime. Ensure department meeting minutes are completed and emailed timely. Uphold department and hospital policies and model respectful behavior; address issues promptly. Promote a team environment and encourage participation through example and encouragement. Communication/Working Relationships/Training Greet patients, family members and visitors; direct them to the appropriate area promptly. Answer questions and provide information per department and hospital guidelines. Notify departments of delays or late appointments; keep patients informed of wait times. Attend mandatory in-services and departmental meetings in a timely manner. Exhibit courtesy and respect when dealing with others; respond to colleagues professionally. Answer all incoming calls within three rings; follow standard protocols when contacting physicians and departments to facilitate patient care. Communicate problems to supervisory personnel and participate in corrective actions. Anticipate needs of co-workers and department; adapt to changing requirements of the job. Organizational Responsibilities Associate complies with organizational requirements: attends meetings, completes mandatory education and health requirements, maintains licenses and certifications, follows universal precautions, and adheres to policies. May work overtime or additional shifts as required. Commitment to Beacon’s Six-point Operating System Leverage innovation everywhere. Cultivate human talent. Embrace performance improvement. Build greatness through accountability. Use information to improve and advance. Communicate clearly and continuously. Education And Experience High school diploma or equivalent preferred; minimum age 17. One year of clerical/computer experience preferred. Medical terminology course required within first year. Additional college-level courses in medical practices desired. CHAA and/or CMA certification highly preferred. Knowledge & Skills Basic office and keyboarding skills; ability to type at least 40 wpm; access to reference materials and office equipment. Effective telephone skills for relay of patient and physician orders. Proficient computer skills; data entry, word processing, spreadsheets; ability to use multiple databases (e.g., Star Navigator, Cerner, Rev Spring, Indiana Medicaid Portal, R1 Insurance Verification Tool, WebForm Imprint, PHS, PCA, pager system, Insurance Rolodex). Understanding of Point of Service collections; ability to explain to patients as needed. Basic knowledge of medical terminology and private insurance coverage. Strong interpersonal skills for interaction with patients and collaboration with other departments and physicians’ offices. Clear verbal communication; ability to interview patients and communicate with departments and physician offices. Good listening skills; sensitivity to non-English speakers. Ability to follow Beacon’s confidentiality policy; maintain composure in stressful situations. Ability to use good judgment in challenging situations; basic math for Point of Service payments. Working Conditions Possible exposure to biohazards in a patient care area. Flexible schedule including evenings, nights, weekends and holidays as needed. Ability to work in a quality-focused, multi-priority environment with frequent stress and timely registrations. Physical Demands Physical ability to walk moderate distances, climb stairs, lift up to 25 lbs, reach, bend, stoop, twist, etc., to perform essential functions. #J-18808-Ljbffr