Patient Access Representative - Internal Agency - Baton Rouge

Job Title

Patient Access Representative

Job Description

The Patient Access Representative facilitates a welcome and easy access to the facility and is responsible for establishing an encounter for any patient who meets the guidelines for hospital service. The PAR ensures that all data entry is accurate, including demographic and financial information for each account. The PAR has numerous procedural requirements, including data elements, insurance verification, and authorization for services; collections for all patient portions including prior balances; and balancing of cash at shift end. The PAR communicates directly with patients and families, physicians, nurses, insurance companies, and third party payers. The PAR has the ability to, and serves as, team lead, lean Process improvement participant, new hire preceptor/mentor and/or auditor for regulatory and billing compliance.

Responsibilities

Customer Service:

• Effectively meets customer needs, builds productive customer relationships, and takes responsibility for customer satisfaction and loyalty.
• Represents the Patient Access department in a professional, courteous manner at ALL times.
• Asks patients if they may have special needs.
• Calls patients by name.
• Greets patients in a courteous and professional manner.

Quality:

• Adheres to the Passport accuracy percentage rate of 97.5 or above on a consistent basis when registering accounts.
• Supports the flexible needs of the department to accommodate patient volume in all areas of the hospital. This may require assignment to another area of the department, and shift change.
• Supports the department in achieving established performance targets.
• Completes training required as needed.
• Demonstrates reliability and dependability by reporting to work when scheduled.

Financial Collections:

• Calculates and collects the estimated patient portion, based on benefits and contract reimbursement as well as prior balances.
• Utilizes appropriate language and behavior to collect patient financial responsibility.
• Collects co-payments, deductibles, deposits and/or amounts due on previous accounts.
• Demonstrates knowledge and ability to review notes on all pre-admitted accounts and discuss with customer in a courteous and professional manner.
• Demonstrates knowledge and ability to review and explain previous accounts.
• Demonstrates knowledge and ability to complete account acknowledgement forms when appropriate.
• Collects cash, prints receipts, and balances cash drawers.

Insurance and Benefits Knowledge:

• Demonstrates knowledge of insurance plans.
• Verifies eligibility and obtains necessary authorizations for services rendered.
• Completes Medicare Secondary Payor Questionnaire.
• Utilizes online eligibility.
• Obtains authorization/verification of required insurance companies.
• Utilizes appropriate software and worksheets to calculate patient financial responsibility.
• Performs financial assessment for appropriate program assistance.
• Utilizes appropriate guidelines to assist patient with financial responsibility.
• Demonstrates accuracy in selected insurance plans (I-plans).

Registration:

• Serves in a team lead role (if assigned).
• Participates in/assists with performance improvement initiatives and demonstrates an understanding and compliance of all department policies and procedures.
• Mentors and trains other associates.
• Acts as auditor for regulatory and billing compliance.

Other Duties as Assigned:

• Performs all other duties as assigned.

Qualifications

Education: High School diploma or equivalent

Experience: 2 years relevant experience in the healthcare industry. Related certification (e.g. Certified Coder, Certified Medical Assistant) substitutes for 1 year of experience.