Patient Access Rep

ESSENTIAL DUTIES & RESPONSIBILITIES:

This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that  are required of the employee.

• Maintains proficiency in the registration/admissions system by registering patients, gathering complete and accurate insurance and Medicare information, and performing basic insurance eligibility searches
• Ensures complete physician testing orders are in-hand at time of registration
• Maintains proficiency by checking medical compliance on tests requiring medical necessity requirements by utilizing computer software
• Demonstrates an understanding of the Medicare Compliance process, and maintains proficiency in processing, completion, and presentation of an Advance Beneficiary Notice (ABN)
• Identifies non-participating insurances and/or out-of-network plans; takes necessary steps to inform patients and physicians regarding options, including but not limited to canceling appointments
• Provides courteous and accurate patient and hospital information with way finding instructions for patients, families, visitors, and ancillary areas
• Prepares documents for imaging/scanning into electronic medical record (EMR)
• Explains processes and forms to patients prior to securing signatures and ensures that all documents are properly signed and witnessed as required
• Provides accurate patient financial estimates and will collect upfront patient financial responsibilities
• Assists with all possible account resolutions pertaining to patient balances
• Performs PBX Operator duties. Answers and completes telephone, paging, and other communications efficiently adhering to departmental policies and procedures. Utilizes secured communication system for physician and employee on-call needs/schedules, and emergency notifications. Monitors emergency alarms and code alerts
• Monitors house-wide security camera system
• Participates in the quality improvement plan, quality control applications, and any other departmental research or studies
• Works collaboratively with team members to ensure patient safety and optimal outcomes, by effectively utilizing conflict resolution, constructive feedback skills, and problem-solving abilities
• Fosters positive internal and external customer relations
• Works in accordance with applicable state and federal law and the uniqueness of reimbursement systems
• Maintains knowledge about and acts in accordance with law and procedures regarding patient confidentiality and release of information, legal requirements for reporting abuse, and advance directives
• Performs duties and responsibilities in a safe manner and reports any unsafe work conditions or work hazards to the manager
• Participates in the department’s Performance Improvement Plan as appropriate to the job responsibilities, including Quality Measures and Customer Service Measures
• Possesses knowledge of hospital policies and the functions of the other departments
• Ensures compliance with all Regulatory Standards, organizational policies and procedures, as well as patient care protocols
• Maintains competency through departmental and organizational core competencies. Completes all required education and keeps education file up to date

CORE COMPETENCIES:

• Values Every Voice: Seeks to understand different perspectives and cultures; contributes to a work climate where the contributions of all individuals are valued and supported
• Shows Courage: Faces difficult issues and supports others who do the same; is willing to champion an idea or position despite dissent or political risk; provides direct and actionable feedback
• Leans Into New Ideas: Learns quickly when facing new situations; experiments to find new solutions and extracts lessons learned from failures and mistakes
• Instills Trust: Follows through on commitments and keeps confidences; is seen as direct and truthful, shows consistency between words and actions
• Plans and aligns: Sets objectives to align with broader organizational goals; breaks down objectives into appropriate initiatives and actions; anticipates and adjusts effective contingency plans
• Builds Effective Teams: Establishes common objectives and a shared mindset; creates a feeling of belonging and strong team morale; fosters open dialogue and collaboration among the team
• Business Insight: Uses knowledge of business drivers to guide actions; keeps up with current and possible future practices and trends in the with the competition and in the marketplace

Education: 

• High school diploma or equivalent

Experience:

• 1 year of registration and scheduling experience in a physician office or hospital setting

Skills

• Data entry skills with a strong emphasis on precision
• Capable of managing several tasks with varying degrees of urgency
• Exceptional customer and phone service skills, demonstrating courteous and professional communication with patients, visitors, ancillary departments, physicians, and their offices,

Preferred:

• Medical terminology
• Knowledge of testing procedures