Patient Access Representative

Job Description

Job Description

We are searching for a Patient Access Representativer to generate clean bills for primary, secondary and tertiary payers, maximize upfront collections, minimize exposure of accounts at risk, ensure clean account receivable balances, maximize self pay collections, and effectively manage the interdepartmental workflow within the revenue cycle.

Duties include but are not limited to:

• Ensures patients and relatives are interviewed to obtain necessary personal and financial information needed for admission/registration of the patient.
• Verifies insurance benefits of the patient and fully documents the verification process in the system.
• Performs all admitting/registration activities to ensure that complete and accurate information is entered into the system in a timely manner.
• Implements policies and procedures for admission/registration of all patients.
• Ensures that eligibility is re-verified when applicable. (e.g. Medicare and Medi-Cal patients)
• Ensures that daily census is accurate, in both paper and system formats. Accuracy includes patient location and program type codes.
• Completes all required forms for admission/registration of a patient and ensures that all required documentation is given to the patient and/or patient's family.
• Enters complete and accurate documentation into the system describing all patient related admitting/registration activities.
• Ensure that all patients have been given full information related to their estimated financial responsibilities to the hospital.
• Ensures that estimated out-of-pocket requirements have been appropriately calculated and
• entered into the system.
• Collects the estimated out-of-pocket requirements prior to the patient's discharge.
• Fully documents all collection efforts into the system.
• Reviews the out-of-pocket yield report daily to ensure that collection efforts meet the hospital-specific target for upfront collections.
• For situations of financial difficulties, ensures that patients are given applicable information related to payment options, such as the healthcare credit line, time payments and information related to the hospital's financial assistance processes. Ensures that these financial arrangements are finalized prior to the patient's discharge.
• Monitors eligible days/visits and disseminates relevant information to clinical staff, MDs, other Revenue Cycle related departments and Administration in a timely manner.
• Ensures full communication is given to patients of eligible days/visits and "At-Risk" notification is given to patients or the patient's guarantor, in writing when applicable in a timely manner.
• Monitors all information related to actual denial activity and disseminates relevant information to clinical staff, MDs, other Revenue Cycle related departments and Administration.
• Prepares requests for adjustments, refunds, transfers when needed to accurate reflect appropriate AR balances and submits for approval.
• Fully documents all transaction requests into the system.
• Monitors all self pay accounts to ensure patients have been quoted applicable self-pay rates and that accounts are appropriately contractualized to the self-pay rate.
• Monitors all self-pay balances of patients on time payment plans to verify compliance with the program and contact the patient if non-compliance occurs to make further arrangements to bring the account current.
• Ensures all collection activities are in compliance with State and Federal collection laws.
• Demonstrates understanding of the various "Self Pay" account classifications and their applicable patient statement processes.
• Review all self-pay balances with credit balances to ensure the balance is accurate and processes all refunds (both by check and credit card) for approval in a timely manner.
• Works effectively with Assessment & Referral staff to maximize all pre-admission activities.
• Works effectively with Case Management staff to minimize the potential for clinical denials.
• Works effectively with the Centralized Business Office to maximize the overall collection efforts of the hospital.

Requirements

• Education: High School degree or equivalent required. Bachelor's degree preferred.
• Licenses: None required.
• Experience: Three to five year admitting and/or Financial Counseling preferred.

• Knowledge, Skills & Abilities:
  • Must have basic PC skills that include a combination of working in a Windows Operating System and Microsoft Outlook, Word and Excel.
  • Has knowledge of governmental and managed care payer requirements.
  • Demonstrates understanding of the various "Self Pay" account classifications and their applicable patient statement processes.
  • Understands the data elements required to generate a clean bill.
  • Understands the importance of maintaining confidentiality; able to maintain confidentiality under HIPAA standards.
  • Must have the ability to exercise a high degree of diplomacy and tact; excellent customer services and interpersonal communication skills; Cultural sensitivity and demonstrated ability to work with diverse people groups.
  • Well developed verbal and written communication skills in English; Additional language abilities desirable.6. Knowledge of basic math and modern office procedures.
  • Ability to work well under pressure with minimal supervision.
  • Ability to remain seated at switchboard for long periods of time without significant discomfort or distress.

• Ability to effectively interact with persons of widely diverse roles, backgrounds, cultures, and socio-economic classes, those in crises or resistant or negative toward organization

• Screening: Must successfully pass background check, drug screen, physical and be able to provide positive employment references.
• Physical Demands: With or without reasonable accommodations, must be able to stoop, kneel, crouch, reach, stand for sustained period of time, walk, pull, lift, raise and move objects from position to position (up to 50 lbs), finger grasp; feel sizes, shapes, temperatures, and textures; express or exchange ideas orally and potentially loudly, accurately, or quickly; visually detect, determine, perceive, identify, recognize, judge, observe, inspect, assess; perceive the nature of sound with or without correction; perform repetitive motions of the wrist, hands, or fingers. Typing, data entry (finger dexterity) and ability to hold hands steady on keyboard when typing. Sit at extended period of time with erect posture. Reading forms/computer screens. Ability to communicate verbally over the phone.

This job description is not intended to be all-inclusive. Employee may perform other related duties to meet the ongoing needs of the hospital.

If you are among the most competitive and qualified candidates for the job, you will be contacted directly by one of our hiring managers. Due to the high volume of applications we receive, we are unable to respond to individual inquiries regarding your application status. Good Luck & we hope to meet you soon!

Dallas Behavioral Healthcare Hospital is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

Benefits

Full-time employees are eligible for medical, dental, vision, company paid disability, 401(k) and a generous amount of paid time off.