Job Description

The Patient Access Representative II in the emergency room is responsible for assisting patients with registration, verifying insurance information, and ensuring accurate data entry during admissions. This role requires strong communication skills to facilitate interactions between patients, clinical staff, and external parties while maintaining confidentiality and efficiency in a fast-paced environment. Additionally, the representative helps resolve patient concerns and supports administrative functions to streamline emergency room operations.

1. Customer Service
2. Consistently demonstrates a positive attitude. Fosters teamwork and offers assists others. Acknowledges and responds tactfully to all requests. Shows consideration and sensitivity during interactions with patients, family members, and team members by demonstrating listening skills and cooperation. Communicates and interacts with others in a professional, responsible, cooperative manner. Adheres to organizational and departmental policies and procedures.
3. Follows AIDET service standards (Acknowledge, Introduce, Duration, Explain, and Thank) during interactions with internal and external customers to promote positive communications and exceptional service.
4. Courteously handles incoming calls and inquiries and conducts timely and appropriate follow up, including documentation.
5. Demonstrates solid decision-making skills, reflecting a balance between mission and financial obligations.
6. Consistently interacts with sensitivity to others and is responsive to individual needs and concerns. Exhibits excellent customer service and communication skills, with the ability to effectively communicate with anxious patients, family members, or representatives.
7. Asks patients if they may have special needs.
8. Calls patients by name.
9. Follows approved scripting during interactions with internal and external customers.
10. Quality
11. Adheres to the Passport accuracy percentage rate of 97.5 or above on a consistent basis when registering accounts.
12. 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.
13. Supports the department in achieving established performance targets.
14. Completes training required as needed.
15. Demonstrates reliability and dependability by reporting to work when scheduled.
16. Financial Collections
17. Calculates and collects the estimated patient portion, based on benefits and contract reimbursement as well as prior balances.
18. Utilizes appropriate language and behavior to collect patient financial responsibility.
19. Collects co-payments, deductibles, deposits and/or amounts due on previous accounts.
20. Demonstrates knowledge and ability to review notes on all pre-admitted accounts and discuss with customer in a courteous and professional manner.
21. Demonstrates knowledge and ability to review and explain previous accounts.
22. Demonstrates knowledge and ability to complete account acknowledgement forms when appropriate.
23. Collects cash, prints receipts, and balances cash drawers.
24. Insurance and Benefits Knowledge
25. Demonstrates knowledge of insurance plans.
26. Verifies eligibility and obtains necessary authorizations for services rendered.
27. Completes Medicare Secondary Payor Questionnaire.
28. Utilizes online eligibility.
29. Obtains authorization/verification of required insurance companies.
30. Utilizes appropriate software and worksheets to calculate patient financial responsibility.
31. Performs financial assessment for appropriate program assistance.
32. Utilizes appropriate guidelines to assist patient with financial responsibility.
33. Demonstrates accuracy in selected insurance plans (I-plans).
34. Registration
35. Obtains and accurately inputs all requires data elements for registration, including patient demographic, financial information, guarantor information, and relevant notes associated with the encounter.
36. Accurately identifies and searches for patients in the EMR, using the national patient identifiers, and selects the correct patient record. Creates new medical records when a patient is not present in the Master Patient Index. Avoids creating duplicate medical records.
37. Prioritizes and completes registration in a consistent, courteous, professional, accurate and timely manner.
38. Ensures each patient is assigned only one medical record number.
39. Selects appropriate patient type based on the department and services required.
40. Communicates the purpose of and obtains patient/legal guardian signatures on all necessary hospital documents such as: hospital consent forms, assignment of benefits, patient rights, etc.
41. Documents in account notes.
42. Ensures orders are received and are consistent with tests/procedures.
43. Gives patient documents that he/she needs to take with him/her to other departments.
44. Scans required documents per policies and procedures during patient registrations including, but not limited to, photo identification, insurance card(s), or external records or documents. Ensure correct document type is selected for each document.
45. Leadership
46. Serves in a team lead role (as assigned).
47. Participates in/assists with performance improvement initiatives and demonstrates an understanding and compliance of all department policies and procedures.
48. Mentors and trains other associates.
49. Proactively monitors assigned department work queues and resolves account issues within defined timeframes.
50. Acts as auditor for regulatory and billing compliance.
51. Other Duties as Assigned
52. Performs all other duties as assigned.

Experience: 2 years relevant experience in the healthcare industry. Related certification (e.g. Certified Coder, Certified Medical

Assistant) substitutes for 1 year of experience

Education: High School diploma or equivalent

Special Skills: Advanced clerical and computer skills, critical thinking skills, ability to work in high-stress situations, professional appearance and behavior, good communication skills, dependability, flexibility, teamwork