Hospital Patient Access Representative

Under the direction of the Patient Access Manager, the Hospital Patient Access Representative must protect the ability to collect for services performed by accurately interviewing and collecting patient demographic, clinical and financial information and recording it into the hospital's Information system. The Hospital Patient Access Representative is also responsible for distributing required patient information in a confidential manner, taking admission reservations from physicians' offices and the Emergency Department, and scheduling the appropriate tests, admissions and communicating with ancillary & clinical departments when necessary. The Hospital Patient Access Representative is responsible for all telecommunication representative duties, as shift assignments can include switchboard operator functions.

EDUCATION:

High school graduate or GED required with a minimum of 2 years related experience or training in patient registration, patient billing, scheduling or medical office.

EXPERIENCE:

• Experience and/or training in medical office practices, pre-certification, medical billing, or Health Information Management preferred.

• Ability to correctly spell and file, and utilize keyboards with ease & proficiency

• A broad knowledge of medical terminology and insurance authorization criteria preferred.

• Basic knowledge of ICD-10 and C PT-4 codes preferred.

• Demonstrated strong people skills, and work history that displays strong attention to detail

The following specific contributions have been identified as essential to your effectiveness in this position.

• Financially clear all scheduled patients - this includes accurately verifying insurance coverage, ensuring authorizations are in place prior to services rendered (preferably at time of scheduling), identify patient out of pocket requirements and make appropriate referrals to facilitated enrollers and/or financial services staff.

• Collect out of pocket from patient before services are rendered using tact and approved scripts and protocols. Understand past balances due as indicated by system and make attempt to collect, and make appropriate referrals to financial counselors.

• Identify return mail flag or bad phone number flag in system and ensure that updated information is obtained from the patient.

• Verify or obtain demographic information every time following accepted protocols and scripting with high degree of accuracy and attention to detail and completes all intake registration screens.

• Schedules appointments for patient test and procedures.

• Complete medical necessity screening on all required patients and enter appropriate code from order or select code from list based on verbiage from order. If medical necessity is not met, then explain to patient the ABN, and contact physician office for potential covered code.

• Complete all regulatory requirements appropriately such as asking Medicare Secondary Payer questions, HIXNY consents and more.

• Review and work items on work lists that are assigned to you and make corrections and revisions within 24 hours of registration.

• Perform admission, discharge and transfer functions accurately and timely.

• Courteously handle incoming phone calls, patient and family member inquiries, and provide direction, guidance and information as appropriate.

• Handles emergency code calls on the emergency line and calmly overhead pages the code or beeps the appropriate individual.

• Completes the on-call list that may require distribution to various departments.

• Notifies insurances of inpatient or observation admissions as required, either by phone, fax or other electronic means.

• Other duties as assigned.

CONTACTS

Daily contacts with physicians and other hospital departments as well as patients and families and general public

PHYSICAL DEMANDS

90% sitting, 10% walking

WORKING CONDITIONS

Standard office equipment and environment

JOB HAZARDS

None

RESPONSIBILITIES:

To fulfill the hospitals mission and vision, all employees must share common responsibilities and quality values, (REACH) to be:

• Respectful

• Efficient

• Accountable

• Caring

• Honest