Patient Access Rep I

Employment Type: Part time Shift: Description: POSITION DESCRIPTION Job Title: Patient Access Representative Il Revision Date: 08/15/2023 Job Code: R01995 Certification/License Required: ☐Yes ☒No POSITION PURPOSE Un Under general supervision, responsible for performing the Patient Access Process components including scheduling, registration, and insurance verification. Interacts with patient and physician office staff to schedule basic and complex future services across a wide scope of clinical departments, including the coordination of multiple services in proper sequence for patients, as well as informing patient/doctor's offices of test preparations, insurance requirements, authorizations and financial responsibility for each service. Analyzes tests/procedures ordered with the signs & symptoms for the studies to make appropriate decisions regarding the services needed and the appointments required. Collaborates with multiple departments to best utilize resources, while accommodating physician preferences and patient needs. Speaks directly with multiple departments and locations to resolve numerous scheduling matters including STAT appointments, approvals, block times and appropriate selection of studies to schedule. Manages physician orders and other clinical documentation to ensure it is available and accurate for clinical staff at the time of patient service. Assists other team members with all scheduling related matters. Responsible for the complete and accurate collection of patient demographic and financial information to create the pre-registration episode. Verifies the patients’ insurance and source of payment and determines the coordination of benefits for scheduled services, as well as prevailing regulatory and 3rd party requirements. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES 1. Interviews patients and physician office staff to obtain information and appropriately schedule patients for future and same day appointments for a wide scope of services including but not limited to advanced imaging, surgical services, sleep studies, respiratory services, cardiology services, vascular services, diabetes education and nutricare services and other services as required using Epic Scheduling applications. 2. Interviews patients and gathers information to assure accurate and timely scheduling, registration, insurance verification and claims submission. 3. Interprets information collected to determine and create comprehensive patient and visit specific medical and billing records. 4. Ensures accuracy and completeness of physician’s orders to support scheduled services, including for surgical cases procedure descriptions, sides and spelling. 5. Determines need for authorization for treatment/procedures and coordination of benefits as required. 6. Utilizes multiple system applications simultaneously to complete the scheduling, order management pre-registration and insurance verification processes including but not limited to Epic, Onbase, Real Time Eligibility, Excel (was/is lists – order translation documents), Cisco phones. 7. Provides information to patients concerning hospital policies and regulatory requirements utilizing effective interpersonal and guest-relations skills. 8. Obtains dates of previous services to determine eligibility for future services using Epic. 9. Uses prior study physician recommendations from Epic to determine appropriate next test to schedule. 10. Translates clinical information on physician orders to clinical order terminology to appropriately schedule patients for future services. 11. Responsible for scheduling STAT appointments, block appointments and obtaining department approvals for complex procedures. 12. Processes requests for scheduling services. Ensures appropriate communication to patient requesting services. 13. On occasion, provides “in charge” support to team members for day-to-day operational issues. 14. Assists with training of new employees and cross training of other team members. 15. Manages all incoming radiology physician orders, surgical routing slips and clinical documentation through use of Epic and Onbase system applications. 16. Provides assistance to other Health System or physician offices staff regarding registration information and procedures. 17. Determines appropriate payment required at point of registration (deposits and minimum charges for non-covered services). 18. Using Epic, pre-registers patients prior to clinical services. 19. Verifies insurance coverage using Real Time Eligibility system tool for all scheduled services to facilitate accurate assignment of financial responsibility and claims submission. 20. Responds to problems and questions from Medical Records, Clinical Departments or PA Teams. 21. Demonstrates understanding of prevailing regulatory and 3rd party requirements (MSP, authorization requirements, medical necessity screening, etc.). 22. Knows where to obtain information to assist PA team members, patients, physician office staff and internal or external customers, and assists them by referring callers to the appropriate sources of information. 23. Identifies opportunities to improve the quality of scheduling, registration and/or verification processes. 24. Responds to patient questions concerning their scheduled services, registration, insurance eligibility and payment requirements as related to their scheduled services. 25. Demonstrates accountability to follow-up with patients concerning requests for information of action regarding their appointment and/or account. 26. Demonstrates team-player abilities and seamless service to patients. 27. Maintains good rapport and cooperative relationships. Approaches conflict in a constructive manner. Helps to identify problems, offer solutions, and participate in their resolution. 28. Maintains the confidentiality of information acquired pertaining to patient, physicians, employees, and visitors to Trinity Health. Discusses patient and hospital information only among appropriate personnel in appropriately private places. 29. Behaves in accordance with the Mission, Vision, and Values of Trinity Health. 30. Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management. OTHER FUNCTIONS AND RESPONSIBILITIES Performs other duties as assigned. REQUIRED EDUCATION, EXPERIENCE AND CERTIFICATION/LICENSURE Education: Requires high school diploma or equivalent. 1-2 years post high school education and/or training or the equivalent. Experience: Minimum of three months experience as a Patient Access Representative l. Certification/Licensure: Certified Healthcare Access Associate (CHAA through NAHAM) Preferred REQUIRED SKILLS AND ABILITIES 1. Demonstrated computerized system application experience. 2. Critical thinking and problem solving skills. 3. Analytical ability to effectively and efficiently resolve registration, scheduling and insurance issues. 4. Demonstrated knowledge of the Revenue Cycle processes, components and terminology. 5. Exceptional interpersonal communication skills to effectively communicate with patients, team members, clinical colleagues, medical staff, external agencies and contacts. 6. Exceptional customer services skills and positive personality attributes. 7. Patience in dealing with ordinary, arduous or emotional patients. 8. Use of telephones and call center technology. 9. Ability to type at 35-40 WPM. This document is intended to describe the generalized duties and responsibilities, the specialized job functions, and the essential requirements of this job. It is not intended to be an exhaustive statement of all supplemental duties, responsibilities, or non-essential requirements or reflect any accommodations made under the American’s with Disability Act, the Michigan Handicapper’s Act, or SJMHS’s Return to Work Program.  Under general supervision, responsible for performing the Patient Access Process components including scheduling, registration, and insurance verification. Interacts with patient and physician office staff to schedule basic and complex future services across a wide scope of clinical departments, including the coordination of multiple services in proper sequence for patients, as well as informing patient/doctor's offices of test preparations, insurance requirements, authorizations and financial responsibility for each service. Analyzes tests/procedures ordered with the signs & symptoms for the studies to make appropriate decisions regarding the services needed and the appointments required. Collaborates with multiple departments to best utilize resources, while accommodating physician preferences and patient needs. Speaks directly with multiple departments and locations to resolve numerous scheduling matters including STAT appointments, approvals, block times and appropriate selection of studies to schedule. Manages physician orders and other clinical documentation to ensure it is available and accurate for clinical staff at the time of patient service. Assists other team members with all scheduling related matters. Responsible for the complete and accurate collection of patient demographic and financial information to create the pre-registration episode. Verifies the patients’ insurance and source of payment and determines the coordination of benefits for scheduled services, as well as prevailing regulatory and 3rd party requirements. REQUIRED EDUCATION, EXPERIENCE AND LICENSURE Education: Requires high school diploma or equivalent. 1-2 years post high school education and/or training or the equivalent. Experience: Minimum of six months experience as a Patient Access Representative I Preferred Certification: Certified Healthcare Access Associate (CHAA through NAHAM) REQUIRED SKILLS AND ABILITIES Demonstrated computerized system application experience. Critical thinking and problem-solving skills. Analytical ability to effectively and efficiently resolve registration, scheduling and insurance issues. Demonstrated knowledge of the Revenue Cycle processes, components and terminology. Exceptional interpersonal communication skills to effectively communicate with patients, team members, clinical colleagues, medical staff, external agencies and contacts. Exceptional customer services skills and positive personality attributes. Patience in dealing with ordinary, arduous or emotional patients. Use of telephones and call center technology. Ability to type at 35-40 WPM. Our Commitment to Diversity and Inclusion Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law. Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. Together, we’re 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, our system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations, and many other health and well-being services. Based in Livonia, Michigan, in fiscal year 2023, we invested $1.5 billion in our communities through charity care and other community benefit programs. For more information, visit http://www.trinity-health.org. You can also follow Trinity Health on LinkedIn.