Patient Access Representative - Physical Therapy East - Full-time - AVALA Hospital - RH485

Patient Access Representative

Under the supervision of the Director of Hand Therapy, the Patient Access Rep is responsible for obtaining accurate patient demographics and insurance information during the patient interview process; the process includes in-person, and phone interviews, corrects information as needed. Assists Patient Access Rep/Verification with obtaining prior authorization and tracking therapy caps to avoid denials. Processes the registration including obtaining the patients signature on the Authorization for Treatment, Advanced Beneficiary Notice (ABN) and completing the Medicare Secondary Payer (MSP) questionnaire. Scans all necessary documentation into Cerner. Collects co-payments, estimated co-insurance and deductibles, which includes phone calls to patients to discuss financial responsibility prior to service as well as collecting at time of service. Answers incoming phone calls and assist caller as needed. And any other duties assigned by Director of Hand Therapy.

Essential Duties and Responsibilities Registration Front Desk:

• Able to handle heavy phone volumes, ensures that callers are transferred to the appropriate department and or person. Answers calls in a timely manner; identifies department and self when answering the telephone. Able to handle all codes and stat calls proficiently.
• Handles ALL medical records for Physical/Occupational Therapy Office.
• Handles ALL patient chart preparation, ensuring that all packets are accurate
• Scans patient documents from the Therapist, Doctor, and/or Insurance into patient's charts.
• Handles all scheduling and rescheduling for Physical Therapy Office, including ALL physical and occupational new and recurring appointments.
• Post payments to patient's accounts.
• Fax Plan of Care to Doctor Offices for approvals on extensions of patient's visits.
• Assists with obtaining prior authorization and tracks therapy caps to avoid denials.
• Verifies insurance and benefits coverage on ALL physical and occupational therapy patients prior to their appointment.
• Verifies that patient demographic information is accurate and ensures that insurance cards, consents and other admission documents are complete and in order. Makes a copy of these cards and scans into Cerner.
• Ability to explain required forms to the patient in detail, i.e.: Authorization for Treatment, Advanced Beneficiary Notice (ABN), Medicare Secondary Payer (MSP) questionnaire. Obtains required signatures as needed.
• As part of the pre-registration process, contacts patient to verify demographic information, insurance information, and MSP questionnaire. Informs patients of estimated balance due and collects monies due at time of service.
• Demonstrates knowledge of all features and functions of Cerner scheduling, accounts, and documentation).
• Notifies appropriate staff regarding any issues or concerns in a timely manner.
• Other duties as assigned by the Director of Hand Therapy or COO.

Other Font Office duties/responsibilities:

• Maintains cleanliness and order in Therapy Front Office and Lobby/Reception waiting area, including emptying trash can if necessary.
• Prepares coffee each morning and each afternoon for Lobby/Reception waiting room.
• Keeps coffee supplies stocked and coffee area clean, using Cavi wipes for sanitation as necessary.
• Maintains all aspects of lobby/reception waiting area is the appropriate temperature and is comfortable for patients.

Core Competencies Action Orientation - Targets and achieves results, overcomes obstacles, accepts responsibility, establishes standards and responsibilities, creates a results-oriented environment, and follows through on actions. Communications - Communicates well both verbally and in writing. Effectively conveys and shares information and ideas with others. Listens carefully and understands various viewpoints. Presents ideas clearly and concisely and understands relevant detail in presented information. Creativity/Innovation - Generates novel ideas and develops or improves existing and new systems that challenge the status quo, takes risks, and encourages innovation. Critical Judgment - Possesses the ability to define issues and focus on achieving workable solutions. Consistently does the right thing by performing with reliability. Customer Orientation - Listens to customers, builds customer confidence, increases customer satisfaction, ensures commitments are met, sets appropriate customer expectations, and responds to customer needs. Interpersonal Skills - Effectively and productively engages with others and establishes trust, credibility, and confidence with others. Leadership - Motivates, empowers, inspires, collaborates with, and encourages others. Builds consensus when appropriate. Focuses team members on common goals. Teamwork - Knows when and how to attract, develop, reward, and utilize teams to optimize results. Acts to build trust, inspire enthusiasm, encourage others, and help resolve conflicts and develop consensus in creating high-performance teams. Professional Requirements

• Meets dress code standards and adheres to policy.
• Completes annual education requirements.
• Maintains regulatory requirements.
• Maintains patient confidentiality at all times.
• Reports to work on time and as scheduled, completes work within designated time.
• Wears identification while on duty, uses computerized punch time system correctly.
• Completes in-services and returns in a timely fashion.
• Attends annual review and department in-services, as scheduled.
• Attends staff meetings annually, reads and returns all monthly staff meeting minutes.
• Represents the organization in a positive and professional manner.
• Actively participates in performance improvement and continuous quality improvement (CQI) activities.
• Complies with all organizational policies regarding ethical business practices.
• Communicates the mission, ethics and goals of the hospital, as well as the focus statement of the department.
• Promotes professional growth of subordinates by sharing knowledge and/or directing them to sources if information appropriate to given situation. Utilizes journals, books, etc. to learn and/or improve new techniques and equipment.
• Assists other staff members in performing any duty that enhances the delivery of patient care.

Regulatory Requirements

• High school diploma.
• Two (2) or more years' experience with Medical Front Desk Preferred.

Skills

• Ability to communicate effectively in English, both verbally and in writing.
• Basic computer knowledge.

Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. This position is very active and requires repetitive motions, standing, walking, bending, kneeling and stooping all day. The employee must frequently lift or move items weighing up to 20 pounds.