Patient Access Representative I

Patient Access Representative I, Part Time, Nights

UM Shore Medical Center at Easton - 219 S. Washington Street Easton, MD 21601

Schedule: 1030p-7a Week 1 Mon, Friday, Sat Week 2 Sun, Monday, Friday Schedule may vary during the first couple months of training

Under general supervision, performs scheduling, registration, pre-admission processing, wayfinding, and other administrative duties, while adhering to the department specific standards for data entry and patient selection. The additional duties of this role can include verification of insurance benefit eligibility, insurance pre-certification and authorization, and estimates creation and/or finalization.

Works with the care teams and revenue cycle to identify and eliminate barriers to access, reimbursement and affordable care. Provides education to the patient and family regarding the financial clearance process, and offer information regarding estimated cost of services and financial assistance opportunities. Performs specific administrative and Admission, Discharge and Transfer (ADT) functions and performs these duties in multiple clinics and registration areas within the institution.

Principal Responsibilities and Tasks

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 duties performed by personnel so classified.

• Serves as the first point of contact for patients and visitors who enter the facilities and is responsible for all aspects of customer service for Patient Access/Patient Administrative Services areas in a manner that ensures a customer focused, quality conscious work climate recognizing that patients visits are filled with anxiety and unknowns.
• Primary functions include focusing on interpersonal skills, data collection, the ability to assess situations, and to assist 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 collection in Epic, provides cost estimates, securing pre-certifications and/or pre-notifications for patient services, collection of co-pay and deposits prior to services and providing financial assistance to patient.
• Provides wayfinding to all clinics which Patient Administrative Services provides registration assistance. Staff must be aware of clinic locations in order to safely and efficiently navigate patients to their appointments.
• Maintains regulatory and functional knowledge of all registration information required, which ensures timely and accurate reporting/billing; also 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 the proper procedures and requirements to patients.
• Communicates coverage issues to the service areas; works with patients and staff to resolve.
• Ensures accuracy and completion of paperwork, prior to filing admissions. Contacts physician/clinical staff to assist with incomplete patient registration paperwork. Distributes admission documents if required.
• Maintains department scheduling templates for applicable providers in outpatient department locations. Ensuring appropriate scheduling utilization.
• Maintains consistent contact with the Care Management team and Social Work departments to ensure required information has been obtained for reimbursement, and that pre-admission and pre-certification requirements are followed.
• Assists supervisor with training of new Admitting staff by demonstrating department operating processes and procedures.

Work Experience

Completion of a high school level education with attainment of a high school diploma or a State High School Equivalency Certificate (GED) is required. Certification and memberships to local organizations such as AAHAM, NAHAM, etc. preferred. 1 year of work experience in a clerical, customer service or receptionist position, preferably in a healthcare setting is required. 2 years' work experience preferred.