Pre Registration Patient Access Associate

MAIN FUNCTION:

The Pre-Registration Patient Access Associate plays a critical role in ensuring that patients are fully prepared for their scheduled healthcare services by accurately estimating financial responsibilities and conducting thorough pre-registration processes. This includes pulling daily reports for scheduled services, identifying patients based on insurance type, creating estimates for patients with commercial and Medicare coverage, and conducting pre-registration calls to verify demographic information, insurance details, appointment specifics, and providing directions to the service location.

DUTIES AND RESPONSIBILITIES:

1. Accurately estimate patient responsibility for upcoming services and communicate these estimates to patients.
2. Document prior unpaid outstanding prior balances and add with the estimate to create “Total Guarantor Responsibility”.
3. Request payment, over the phone, for estimated service costs and any outstanding balances before appointments.
4. Explain in detail patients' insurance coverage and responsibilities, ensuring clarity and understanding.
5. Assist patients with navigating payment and financing options for the patient cost-share for future services and prior balances.
6. Pre-Qualify guarantors whose remaining balances are over $500 and don’t qualify for Medicaid, charity or other financial assistance programs.
7. Coordinate closely with billing and insurance verification teams to gather accurate financial information for patient pre-registration.
8. Pull daily reports for scheduled services, including outpatient services/therapies, surgery, GI/Endo, radiology, and dialysis.
9. Provide patients with clear directions to the service location for the day of their appointment.
10. Perform other duties as assigned to support the Patient Access Services Department.

EDUCATION:

High school diploma or GED required; some college or Associate's/Bachelor's degree in business, finance, or related field preferred.

QUALIFICATIONS:

Knowledge of medical terminology, healthcare billing, and insurance verification processes.

Strong financial acumen and a thorough understanding of patient responsibility amounts, including copays, deductibles, and coinsurance.

Excellent communication, negotiation, and interpersonal skills, with the ability to explain complex financial information in a clear and compassionate manner.

Proficiency in using hospital information systems, electronic health records, and office software.

PHYSICAL DEMANDS:

Requires extended periods of standing or sitting.

Requires extended periods of discussing patient responsibility balances with patients over the phone.

EXPOSURE CATEGORY:

Category III. Tasks that involve no exposure to blood, body fluids, or tissues. Category I tasks are not a condition of employment.