Job Description

As the first point of contact for patients and visitors to Pipeline Health’s facilities, the Patient Access Representative (PAR) plays an important role in guiding patients through the admissions process, conducting eligibility screening, and preparing patient information for clinical departmentsThe PAR is responsible for the following, but not limited to, obtaining demographic, insurance, and financial information, explaining all required forms and obtain the necessary signatures from the patients. Verifies insurance eligibility and benefits and ensures all notifications and authorizations are completed within the required timeframes collects and posts payments in the computer system and generates a payment receipt. Actively and consistently contributes to department operations and communications, behaves in a manner consistent with the mission, vision, and values of Pipeline Health, upholding standards of AIDET (Acknowledge, Introduce, Duration, Explanation, Thank you) patient communication.

Essential Functions:

• Greet patients, visitors, and caregivers upon arrival.
• Collect patient information, including demographic data, insurance information, and medical history.
• Verify patient insurance eligibility and benefits.
• Schedules appointments.
• Responds to patient and caregivers’ inquiries to routine and sensitive topics always in a compassionate and respectful manner.
• Collects copayments and other payments from patients.
• Identifies outstanding balances from patient’s previous visits and attempts to collect any amount due.
• Updates patient records and files.
• Answers telephones and directs calls to appropriate staff and departments.
• Provides information such as directions, visiting hours, or patient status information.
• Receives and routes messages or documents, such as laboratory results, to appropriate staff.
• Transmits correspondence or medical records by mail, e-mail, or fax.
• Uses clear, concise, professional communication with coworkers, patients, all customers internal and external.
• Uses AIDET in interactions with patients and family members.
• Acts with a sense of urgency when performing tasks.
• Basic unit/department maintenance such as keeping files, drawers, cabinets free from unnecessary clutter.
• Reports on any equipment and or environmental issues for repair.
• Abides by HIPAA (Health Insurance Portability and Accountability Act) regulations.
• Speaks up to stop the line and escalates potential safety events if necessary.
• Completes and attends monthly training assigned.
• May float to other areas of the hospital as needed.
• Other duties as assigned.

Behavioral Standards:

• Treats everyone as their customer; utilizes scripting and other tools to ensure consistency in customer service; Expresses recognition and shows appreciation to others; fully utilizes AIDET principles; responds quickly to handle requests, complaints, and questions; displays a positive attitude.
• Demonstrates the highest level of professionalism, passion and care when interacting with patients, families, physicians, and hospital staff members.
• Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential, embracing ingenuity to service our customers.

Communication/Knowledge:

• Understanding of Insurance policies and procedures.
• Bi-lingual in English and Spanish preferred; speak, read and write proficiently in English with the ability to speak and interact in Spanish as needed.
• Working knowledge of medical terminology.
• Wears nametag properly; follows dress code policy; answers phone correctly and promptly; is prepared for meetings; meets deadlines; does not participate in gossip; acts ethically and treats others with respect; respects customer’s and co-worker’s time; establishes and maintains effective relationships with customers and co-workers.

Collaboration/Teamwork:

• Attends staff meetings; follows HIPAA guidelines; follows patient rights policy; complies with the compliance program; demonstrates knowledge of role in a disaster; demonstrates knowledge of fire and fire drill procedures; working knowledge of hospital emergency codes; always utilizes standard precautions in the clinical setting; safely manages the environment of care by demonstrating a working knowledge of the requirements of the: Life Safety program, Utilities Management program, Hazardous Materials program, Emergency Preparedness program, Safety Management program, Medical Equipment Management program, Security Management program

Experience:

• At least one (1) year of experience in customer service.
• At least one (1) year of experience working in the healthcare setting preferred.
• Adaptable to changing work schedules and patient needs.
• Ability to read, write, and comprehend medical terminology.
• Prior experience collecting financial payments and understanding insurance a plus.
• Critical thinking, service excellence and good interpersonal communication skills, ability to read/comprehend written instructions, strong organizational skills, ability to follow verbal instructions, and PC (computer) skills.
• A capacity to learn, synthesize, make critical judgments, work independently, place patients and families first, and collaborate with the team members who are recognized leaders within health care.