Patient Access Representative II

Description

Purpose of Job

This position is responsible for complete and accurate pre-registration and registration of various patient types, including, inpatient admissions, outpatient, emergency services, and same day surgeries at multiple locations.

Job Functions

1. Efficiently registers patients, in person or via phone, capturing and verifying all required information in order to identify the patient, contact the patient, and receive proper reimbursement for services on initial claim submission.
2. Assigns the appropriate Guarantor for each patient.
3. Ensures patients receive necessary disclosures, privacy information, and signs the Consent to Treat documentation.
4. Verifies insurance eligibility and benefit information using real time eligibility; reviews the insurers response to each verification request and takes appropriate action based on the response to ensure the proper insurance plan and billing address are entered in the system.
5. Completes the MSQ, as appropriate, for patients with Medicare
6. Collects financial obligations from patients and provides financial counseling (including hospital presumptive eligibility (HPE) screenings and applications) and/or estimates when appropriate.
7. Reconciles and performs end of day cashier duties
8. Works with internal staff and third-party payers to obtain information necessary for the registration.
9. Initiates treatment authorization requests and pursues referrals per payer guidelines. Works with clinical staff to determine likely ICD-10, DRG and/or CPT Codes.
10. Ensures Inpatient Notification process to third party payers is completed within established time frames.
11. Assists and refers internal and external customers to proper resources for questions.
12. Provides professional and courteous customer service to internal and external customers.
13. Adheres to strict confidentiality when handing patient information.
14. Meets established quality and productivity standards/requirements.
15. Performs other duties as assigned

Minimum Education/Work Experience

• High School Diploma or equivalent
• 1-2 years healthcare experience
• Familiar with medical terminology
• Strong customer service experience

Knowledge/Skills/Abilities

• Ability to effectively handle high-stress fast paced environment
• Ability to meet and maintain the necessary background checks as aligned with position functions
• Ability to communicate in the English language for effective written and verbal correspondence in order to complete job functions as mentioned above
• Ability to multi-task and high attention to detail
• Ability to perform basic math functions and count money
• Ability to serve patients in a friendly and efficient manner
• Knowledge of basic computer functions and Microsoft Office applications
• Ability to work autonomously and as a team
• Ability to respond appropriately to unpredictable situations and diverse patient populations
• Capable of making independent decision with the use of strong critical thinking and problem-solving skills
• Ability to communicate in the English language for effective written and verbal correspondence in order to complete job functions mentioned above

License/Certification

Preferred Qualifications

• Post-secondary education
• Bilingual

Cognitive and Mental Demands

Time Awareness - Frequent
Writing - Continuous
Initiation of Work - Continuous
Memory - Continuous
Receptiveness to Change - Frequent
Reasoning - Continuous
Required Sequences in Work - Continuous
Problem Solving - Continuous
Attentiveness Duration - Continuous
Social interactions - Frequent
Mathematical Aptitude - Occasional
Conflict Management - Occasional
Reading - Continuous
Detail Oriented - Frequent

Compensation

Many factors are taken into consideration when determining compensation such as: the requirements of the position, experience, education, knowledge, and skills along with location and internal equity. Pay listed does not include any shift, weekend, or other differentials.


Benefits

Ridgeview strives to provide comprehensive and market competitive benefits to meet the needs of our employees and their families.


Click here to view the benefits available.