Patient Access Representative I

Job Requirements

University of Maryland Medical Center

Patient Access Representative I, Full Time, Rotating with holidays and weekends (Floating between locations)

Candidate will receive schedule a month in advance; however, it can be various shifts (days, evenings, nights). one weekend and holidays.

Performs scheduling, registration, pre-admission processing, wayfinding, and other administrative duties in accordance with department-specific standards for data entry and patient selection. May verify insurance benefit eligibility and complete insurance pre-certification and authorization, as well as create and/or finalize cost estimates. Collaborates with care teams and revenue cycle partners to identify and eliminate barriers to access, reimbursement, and affordable care. Educates patients and families on the financial clearance process and provides information regarding estimated costs of services and available financial assistance options. Performs assigned administrative and Admission, Discharge, and Transfer (ADT) functions across 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.