What are the responsibilities and job description for the Patient Access Representative position at CRYSTAL CLINIC ORTHOPEDIC CENT?
Position Summary
The Patient Access Representative supports the clinical operations of The Crystal Clinic Orthopaedic Center (CCOC) by performing the registration or clerical functions to ensure patients have prompt access to CCOC services. Will perform call center scheduling, arrival desk, and / or departure activities throughout multiple locations for the Crystal Clinic. Verifies insurance eligibility for upcoming patient appointments.
Essential Job Functions/Accountabilities
Registers patients in an accurate, efficient, and professional manner to insure integrity of patient data in Cerner and Centricity systems; Conducts patient/guarantor interviews, explains hospital policies, financial responsibilities and patient Rights and Responsibilities and Notice of Privacy Practices; Follows check-in procedures consistently for all patients ensuring that all forms are collected, completed, signed, and scanned into systems; Verifies insurance eligibility for upcoming patient appointments using, eligibility system; Collects referring physician demographic information for communication and follow-up; Performs visit preparation, appointment reminders, records and tracks no-show patients, and other point of service activities as assigned. Handles a wide variety of patient inquiries (on the phone or in person) regarding appointments and services to ensure that patients can access CCOC services with minimal hassle or delay; Answers the telephone in a pleasant and courteous manner within three rings, identifying self, organization, location / department.
Identifies co-payments / out-of-pocket expenses, advises patients regarding the need for payments at / or prior to the time of service; Identifies patients in need of financial counseling to collect payments by following CCOC policies and guidelines; Facilitates the cash collection, as needed, for services rendered and ensures payments received are balanced and batched correctly according to CCOC policy.
Schedules appointments (for assigned service line) accurately by following specialty and physician specific guidelines and/or routes the patients to the appropriate area for further follow-up/ scheduling; Processes internet appointment requests and responds to patient according to departmental policy; Ensures same day add-on appointments are communicated to appropriate department personnel and authorization is obtained; Schedules all follow-up appointments or procedures using Electronic Medical Record (EMR) systems and provides proper patient instructions.
Collects referring physician demographic information for communication and follow-up; Performs visit preparation, appointment reminders, records and tracks no-show patients, and other point of service activities as assigned; Communicates with physician’s office when prior authorization / pre-certification are required and not yet on file in systems. Escalates to Patient Access leadership and provides detailed timeline of events as needed.
Communicates to nursing, physicians, technicians, secretaries, and supervisors regarding issues relating to patient wait times, late arrivals, or other delays. Recruits, registers, and trains patients on how to use Patient Portal systems.
Provides back-up coverage and assists in daily office routine when needed in other areas.
Maintains confidentiality of sensitive information including, but not limited to, patient records, charts, hospital documents and employee information without exception, according to HIPAA guidelines.
Maintains up-to-date knowledge of computer systems, insurance / government regulations and Patient Access policies/ procedures used within CCOC.
All other duties not specifically assigned.
Position Requirements
Education: College degree or progress towards degree preferred.
Experience: One (1) to Three (3) years of demonstrated experience in healthcare field or healthcare profession preferred; or minimum 2 years Customer Service required. Use of EMR systems preferred. Must be efficient in one area, scheduling or registration.
Technical Skills: N/A
Certifications/Licenses/Registrations: N/A
