Job Description

The Patient Access Representative delivers high-quality customer service to patients of all ages, their families, visitors, medical staff, clinicians and co-workers, ensuring all interactions are courteous, timely and respectful.

The Patient Access Representative handles all business functions in an assigned clinical department area to include reception, scheduling, and registering patients for appointments and/or procedures. This position also secures the appropriate patient information; ensures that registration data is correct and accurate; validates insurance eligibility, ensuring accurate data entry; collects co-pays, and supports financial counseling and financial clearance, as necessary.

Essential JobStatements

Greet Patients/Answer Telephone
Providesexceptional customer service by welcoming patients andvisitorsin a friendly,professional, and respectfulmannerEnsuresindividualsare respectedand informed,communicatingclearlyandeffectively,andutilizingappropriate languageresources as neededAssistswithtraffic flow in and out of the clinic as needed. Addressespatientneeds promptly, and maintainsacourteous, professional toneat all times

Co-payment Collection &Registration Data
Collectsallpatientco-payments and depositsaccurately perpayer,followingdepartment guidelinesVerifies and updates registration data, including demographic and insurance information.Copies and records insurance information per department standards. Follows department policies for cash handling, including cash reconciliation and deposit preparation

Referral Management

Verifies insurance coverage and understands requirements for HMO, managed care, government and private plans.Secures required referrals/authorizations and links them correctly in the referral module.Obtains needed referrals and authorizations before scheduled procedures, tests,injectionsand surgeries. Communicates plan-specific referral/authorization requirements to patients and providers.Provides pre-payment guidance for self-paypatients and offers financial assistance. Prepares cost estimates, explains paymentexpectationsanddocumentsall interactions in the patient account

Appointment Scheduling, Lab & Test Order Entry
Correctly schedulesclinic appointmentsthroughthemedical records software/communication platformTranscribesphysician orders accurately and completely (i.e.lab test, ancillary test) andrecords them in theappropriate system(s)according to the physician’s instructions and VCUHS policy. Coordinatesthe collection of pre-operative testing and paperwork, whereappropriate

Patient Record/Verify Registration Data
Maintainsproficiencyin all aspects of patient medical record keeping in an organized manner.Assistsinpreparation ofthe chart before the patientvisits If applicable,assistsin breakingdown the chart at the completion of thepatient'svisit.Ensuresthat all patientsarrivedin the appointment scheduling system before the end of the appointment day. Whereappropriate, appointments are documented as “no-shows” or cancellationsbefore the end of the appointment day.Obtainssignatures andcompletesthe required forms including those from managed care and other insurance plans.

E-Documents Management & Scanning
Obtains and scans allappropriatepatientmedicaldocumentation

Miscellaneous Responsibilities

Notifies supervisor of issues involving violation of VCUHS policies or procedures.

Performs other duties as assigned and/orparticipatesin special projectstosupport the mission of VCUHS and department.

Patient Population: N/A

Employment Qualifications

Education Required: HighSchool Diploma or equivalent

Education Preferred: AssociatesorBachelor’s Degree in Accounting, Finance, Business Administration, HealthcareAdministrationor closely related field from an accredited program.

Licensing/ Certification

Licensure Required: N/A

Licensure Preferred: N/A

Certification Required: N/A

Certification Preferred: N/A

Minimum Qualifications

Yearsand TypeofRequiredExperience:

Demonstrated experience using computers, Microsoft Office applications, and web-based platforms

Experience Preferred: Work experience with medical insurance, HMO, managed care, electronic medical billing/order entry/registration systems, and appointment scheduling.

Previous work experience in a healthcare setting,and knowledgeof medical terminology

Other Knowledge,Skillsand Abilities Required: Able to perform daily activities with minimal supervision: beingself-directedin the accomplishment of routine activities.

Other Knowledge,Skillsand AbilitiesPreferred: Depending on assignment,mayberequiredto work off-shifts and/orweekendand holidays.

Working Conditions: Periods of high stress and fluctuating workloads may occur. General office environment. May have periods of constant interruptions. Prolonged periods of working alone.

Physical Requirements

Physical Demands: Lifting/ Carrying(0-50 lbs.), Push/ Pull(0-50 lbs.), Stoop, Kneel, Squat, Crawling, Climbing, Balance, Bending

Work Position: Sitting, Walking, Standing

Additional Physical Requirements/ Hazards

Physical Requirements: Manual dexterity (eye/hand coordination), Perform shift work, Hear alarms/telephone/tape recorder, Repetitive arm/hand movements

Hazards: N/A

Mental/Sensory – Emotional  

Mental/Sensory: Strong Recall, Reasoning, Problem Solving, Hearing, Speak Clearly, Reading, Logical Thinking

Emotional : Fast pace environment, Able to Handle Multiple Priorities, Frequent and Intense Customer Interactions, Able to Adapt to Frequent Change

Rotating

EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.