What are the responsibilities and job description for the PATIENT ACCESS REPRESENTATIVE position at Minnie Hamilton Health System?
PATIENT ACCESS REPRESENTATIVE
The position focuses on providing exceptional customer service as the first point of contact for patients. Patient access representatives play a critical role in creating a welcoming environment, greeting patients warmly, and assisting them with their needs. This includes conducting thorough reviews of patient accounts to ensure that payment arrangements are accurate and comply with regulatory standards.
In this role, representatives verify the accuracy of patient information and ensure adherence to applicable guidelines. They evaluate insurance coverage for various expenses, meticulously checking accounts for accuracy. Their support is vital during audits by insurance companies, as they help resolve discrepancies related to overpayments or other financial concerns.
Additionally, these representatives are responsible for efficiently entering charges, documenting payments, and updating patient account details—all while ensuring that claims are submitted promptly. By prioritizing clear communication and patient support, they enhance the overall patient experience and contribute to the organization’s commitment to quality care.
Essential Duties
1. Patient Registration
- Greet and assist patients upon arrival at the hospital.
- Accurately enter patient information into the hospital's registration system, ensuring all demographic and insurance information is complete and correct.
- Verify patient identity and ensure compliance with privacy regulations.
2. Insurance Verification
- Confirm patient insurance coverage and benefits prior to service.
- Communicate with insurance companies to verify eligibility and obtain authorization for treatment, when necessary.
- Explain insurance benefits and patient financial responsibilities to patients.
3. Financial Counseling
- Discuss payment options and financial arrangements with patients, including setting up payment plans if required.
- Provide estimates of costs for services and procedures and assist patients in understanding their financial obligations.
- Assist patients in applying for financial assistance or charity care programs.
4. Appointment Scheduling
- Schedule patient appointments and procedures efficiently, ensuring minimal wait times and optimal resource utilization.
- Coordinate with healthcare providers to manage scheduling conflicts and ensure timely patient care.
5. Record Keeping and Documentation
- Maintain accurate and up-to-date patient records, including updates to personal information and insurance details.
- Ensure all documentation meets hospital and regulatory standards for accuracy and completeness.
6. Customer Service
- Provide excellent customer service and act as a liaison between patients, families, and healthcare providers.
- Address patient inquiries and concerns promptly and effectively, escalating issues to the appropriate department when necessary.
7. Collaboration with Medical and Administrative Staff
- Work closely with medical staff to ensure seamless patient care and service delivery.
- Collaborate with billing and financial departments to resolve any discrepancies in patient accounts.
8. Compliance and Quality Assurance
- Adhere to hospital policies and procedures, as well as federal and state regulations, to ensure compliance.
- Participate in quality assurance initiatives to improve patient access processes and enhance patient satisfaction.
Qualifications:
- High school diploma or equivalent
- Familiarity with third-party payer requirements
- Strong telephone communication skills
- Understanding of admitting and credit policies
- Proficient in PCs and hospital systems
- At least one year of experience in admitting/insurance billing in healthcare
- Ability to collaborate with the public and hospital departments
- Excellent verbal and written communication skills
- Knowledge of medical terminology preferred
- Competence in typing, third-party follow-up, processing refunds, and evaluating patient account collectability
Physical Requirements:
- Prolonged sitting at a computer, along with frequent walking, standing, and filing, are essential physical activities.
- Ability to read and write clearly in English is required.
- Normal hearing and visual acuity are necessary.
- Effective communication skills are a must.
- Manual dexterity is needed to operate keyboards, fax machines, telephones, and other office equipment.
Mental Requirements:
- Ability to perform complex mental tasks and meet deadlines.
- Capacity to work under stress and adapt to changing workloads.
- Capability to make independent decisions on projects.
- Comprehension of oral and written instructions.
- Effective reading and comprehension skills.
- Strong written and verbal communication skills.
- Good math skills.
- Ability to prioritize tasks.
