Job Description

Shift: 7a-5p

Position Goal

The Patient Access Representative responsibilities may include pre-registration, main registration, payer identification and verification, precertification, and point of service collections. Vital functions include: timely, accurate and complete data gathering and entry in the computer system(s) of patient demographic and benefit information, verification of benefits eligibility and limitations, coordination of benefits, determination and collection of patient’s financial responsibility at the point of service and satisfaction of regulatory requirements. This position is vital to not only the patient satisfaction but the operations of the facility as well as the operational financial success. Essential is the ability to provide excellent customer service to patients, patients’ family members, healthcare providers, medical staff offices, and coworkers.

Position Responsibilities:

• Performs all elements of the patient intake process with proven accuracy by performing Master Patient Index inquiries using established identifiers to ensure non-duplication of medical records numbers .Demographic information is collected/updated in the system including, but not limited to, emergency contact, telephone numbers, and financial information accurately. Completes record before the end of daily shift.
• Benefits are to be identified, verified by computer or telephone, coordinated and entered in the system while fulfilling Medicare requirements and completing the Medicare Secondary Payer Questionnaire accurately.
• Determines and informs patient/guarantor of financial responsibility and collects at point of service, issuing receipts as appropriate to include outstanding balances.
• Appropriately reads and documents notes on each account.
• Consistently provides explanations and information to the patient and obtains signatures as appropriate.
• Accurately scans the patient ID, insurance cards, eligibility responses, orders, payments, receipts, authorizations, notifications, referrals, and signatures to the patient’s account.
• Maintains proficiency in the use of all systems and communication devices essential to the efficient, effective performance of Patient Access functions.
• Proactively determines payer requirements for pre-certification or pre-authorization and obtains the necessary documentation prior to service delivery.
• Obtains required physician order documentation when necessary to complete the patient intake process.
• Supports the department goals for point-of-service collections by identifying the patient responsibility, communicating to the patient or responsible party at pre-registration or registration their financial responsibility to include collecting co-payments/coinsurance/deductibles from the inpatient, outpatient diagnostic or surgery patient prior to service delivery.
• Ensure all forms are completed by the patients and review promissory note obligations.
• Knowledgeable of Current Procedure Terminology Codes (CPT), ICD-10 Codes, and medical terminology.
• Knowledgeable of health insurance, benefit eligibility, and HIPAA (Health Insurance Portability and Accountability Act).
• Assist with calling on precertification, authorizations, pricing of medical charts, pre-registration duties and transport.
• Reviews charts for accuracy and completes charts from prior shifts.
• Knowledgeable of procedures governing the arrival of Joint Commission and other groups.
• Accurately assigns service codes at time of registration and/or room assignments based on established criteria outlined in the procedure manual.
• Responds to emails before the next business day.
• Performs general clerical office duties as required in the Patient Access Office, including but not limited to filing, faxing, scanning and copying documents.
• Actively assist and engage in other areas of the department as needed in order to achieve departmental goals.
• Meets assigned departmental quality assurance, point of service collections, insurance verification, registration time and monthly percentage goals.
• Demonstrate superior prioritization, organizational, and time management skills.
• QA must be completed and all corrections made within two days of batch date.
• Can perform all Code/Alarm procedures.
• Responsible for making sure that Supervisor has most up to date contact information.

Experience: Previous office experience in a hospital or medical office, patient access or financial services preferred. Good math skills and typing proficiency. Must have exceptional customer service skills as well as verbal and non-verbal communication skills.

Education: High School diploma or equivalent required.

Special Qualifications: Ability to work independently. Ability to interact well with the public, i.e. children, adolescents, adults and geriatric. Ability to work in a fast-paced, high-stress environment. Certified Patient Accounts Representative (CPAR) or Certified Healthcare Access Associate (CHAA) preferred.

The Hughston Clinic, The Hughston Foundation, The Hughston Surgical Center, Hughston Clinic Orthopaedics, Hughston Medical, Hughston Orthopaedics Trauma, Hughston Orthopaedics Southeast and Jack Hughston Memorial Hospital participate in E-Verify. This company is an equal opportunity employer that recruits and hires qualified candidates without regard to race, religion, color, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or veteran status.