Patient Access Representative II

Category: Admin Support City: Brownsville State: Tennessee Shift: 0 - Day (United States of America) Job Description Summary: This position will function as a subject matter expert for the department and will help coach and mentor less experienced staff on all aspects of Patient Access Services and the Revenue Cycle. This position is responsible for completing the financial clearance process within PAS and creating the first impression of WTH’s services to patients and families and other external customers. Responsible for obtaining, coordination, and directing information from patients, physician offices, hospital departments, and clinics in order to schedule patient appointments. PAS reps may also be responsible for scheduling patients. ESSENTIAL JOB FUNCTIONS: Ensures that proper insurance payer plan choice and billing address are assigned in the automated patient accounting system. Financial Clearance - Contacts payers to verify insurance eligibility. Refers to the designated area if medical necessity fails or if referrals /authorizations are denied. Pre-Service/ Point of Service Collection - Interprets third-party payer policies to establish patient financial liabilities and work with patients so they understand their patient financial responsibilities. Collect co-payments, co-insurance, and deductibles according to pre-service/ point of service collections policies and procedures. Communication & Miscellaneous - Advises next-level leader of possible postponement or deferrals of any elective/non-emergent admission which has not been approved prior to service date. Maintains accurate files for pre-processing information as required. Demonstrates excellent communication skills and the ability to work with all levels of staff to resolve urgent issues in a prompt and professional manner. Investigates, resolves, and documents patient problems and contact medical staff, nursing staff, ancillary departments, and administration as necessary. Assists with cross training function in areas within Patient Access Services. Performs related responsibilities as required or directed. JOB SPECIFICATIONS: EDUCATION: High School Graduate, or equivalent LICENSURE, REGISTRATION, CERTIFICATION: N/A EXPERIENCE: 2-3 years of health care or related experience required KNOWLEDGE, SKILLS, AND ABILITIES: Demonstrate proficiency and ability performing the following functions: Financial Clearance, Financial Counseling, Scheduling, Registration, ED Registration, and Patient Access. Understanding of healthcare business and finance principles with special emphasis on hospital and physician access services. Demonstrated knowledge of healthcare management, registration, billing, and collection processes for government, grant, and non-government funding sources. Demonstrated detailed working knowledge of Patient Access procedures and healthcare reimbursement to include familiarity with various payer mixes. Comfort with data entry within Revenue Cycle software, patient management systems and Windows-based applications preferred. Strong experience with patient accounting systems and knowledge of word processing and spreadsheet applications. Strong interpersonal skills and the ability to work through a variety of issues in a diplomatic fashion required. NONDISCRIMINATION NOTICE STATEMENT We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, disability, religion, national origin, gender, gender identity, gender expression, marital status, sexual orientation, age, protected veteran status, or any other characteristic protected by law. West Tennessee Healthcare complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered a position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to follow West Tennessee Healthcare’s accommodation precautions to mitigate the spread of illness.