Patient Access Representative - Emergency Department

Job Summary: 

Responsible for accurate and timely patient registration, including medical necessity and insurance eligibility. It involves  providing accurate financial estimates for patients and collecting any upfront financial responsibilities. The Patient Access Registrar will verify that testing orders are correct and present at the time of registration. Additionally, there may be instances where assisting the PBX Operator is required

Essential Duties and 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

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
• Medical terminology
• Knowledge of testing procedures