Patient Access Representative

Position Summary:

Under general supervision, the Patient Access Representative facilitates access to Humboldt General Hospital and Clinic (HGH) services for new and returning patients, coordinates financial arrangements including financial screening and communicates with patients, referral sources, and the treatment team regarding patient access and financial issues. Obtain necessary information, prepare admission/registration forms, gather insurance information and perform other clerical/computer operational tasks related to the authorization, admission and registration of inpatient and outpatients coming into HGH.

Position Designation:

The registration of Inpatients and Outpatients and insures that accurate patient information is collected and that patients are aware of HGH policies and procedures. Arranges for the efficient and orderly answering and direction of incoming and outgoing registrations and communications.

Duties and Responsibilities:

• Must demonstrate ability to tactfully handle difficult situations with patients, families and physicians; excellent problem solving and critical thinking skills
• Must portray a positive, courteous and professional manner to patients, families, visitors, co-workers and physicians, having excellent communication skills, customer service and privacy etiquette
• Must maintain strict confidentiality of patient information, ensuring accuracy and quality of work product
• Greets patients registering for presentation to clinic or to hospital and explains admissions procedures; greets patients, providers or the community over the phone politely and promptly, ensuring timeliness and accuracy of all communications
• Excellent problem solving and critical thinking skills including respect, honesty, integrity, compassion, fairness, innovation and stewardship of resources
• Registers (pre-registration and/or walk-ins) patients referred by doctors for inpatient, outpatient or ambulatory services, as outlined in Admissions manual, in any Department of HGH (Emergency Department, Registration, Clinics, Lab, Radiology, Pharmacy, Labor and Delivery, Clinic, LTC, etc.
• Obtains necessary signatures of consent for treatment, release of information, assignment of benefits and all other admission/billing and compliance forms or census reports; routes forms to appropriate areas
• Accepts reservations for inpatient/outpatient services, gathers necessary patient information including diagnosis, emergency notification numbers and insurance information and payment (cashiering)
• Collects personal and billing information when registering patient, documents insurance coverage and authorizes information in Patient Accounts; inputs patient information via electronic or manual means.
• Collects patient balances, including copayments, coinsurances and deductibles, as well as any former or current balances outstanding. Explains payment and billing processes, responding to billing questions.
• Selected positions will be responsible for pre-authorizations, insurance verification, counseling and compliance questions for all payers, whether inpatients, outpatients or ambulatory
• Assists patients in understanding insurance benefits - refers uninsured patients to financial counselors, explains policies regarding deposits, billing and credit and collections
• Transfers/discharges and readmits to specialty units as directed
• Adheres to current and future organizational Performance Improvement priorities and Quality Assurance
• Understanding and compliance with HIPAA, HITECH, Red Flag and other Privacy and CMS Regulations
• Other duties as assigned.
• Additional Essential Functions as outlined in the Job Description

Position Qualification:

Preferred Minimum Education:

• High school diploma or equivalent
• Knowledge of insurance coverage and billing
• Knowledge of medical terminology
• Minimum two years receptionist/cashier or other related experience/business school training; Hospital, Medical, Office, Billing, Admitting and computer experience preferred;
• Skill in computer literacy and ability to effectively learn new software programs required
• Skill in oral and written communication, including reading comprehension
• Skill in data analysis to gather and update statistics, logs, records and reports
• Ability to type quickly and accurately
• Excellent customer service techniques
• Ability to multi-task and prioritize
• Typing (45 wpm.), data entry, ten-key, fax and copy machine
• Telephone-switchboard answering
• CPR certification

Personal Qualifications:

• Ability to read, write and speak the English language in an understandable manner. Spanish helpful.
• Ability to make independent decisions
• Ability to deal tactfully with personnel, patients, family members, visitors, general public on the phone

Physical Requirements: The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of the job.

• Light to moderate physical effort (lift, carry, push, pull up to 25 lbs.)
• Mostly sedentary work
• Manual dexterity and mobility
• Occasional reaching, stooping, bending, kneeling, crouching
• Visual acuity with or without correction

Working Conditions: The above statements are intended to describe the general nature and level of work typically performed by an employee in this position. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.

• May be exposed to infections and contagious diseases.
• Works in clean, air-conditioned, well-lit environment.
• Contact with patients/visitors/personnel under wide variety of circumstances.
• May be exposed to long hours and stressful situations, including emergencies and disasters

Required Protective Equipment:

Gown, medical gloves, face shield as necessary and other equipment as required by OSHA regulations and HGH policy.

Review: I have read and understand the job description for the position of Patient Access Representative. The expectations of my job have been explained to me and I have had an opportunity to ask questions. I acknowledge that the contents of this job description are intended to describe the general nature and level of work being performed by person assigned to this position and are not to be construed as an exhaustive list of all responsibilities, duties, and skills of the person so classified. Further, I certify that I am capable of meeting the personal/physical/licensure/certification requirements of this position.

FLSA Status: Non-Exempt, hourly