Patient Access Rep

Position Summary

Perform patient registration and provide insurance benefits interpretation and counseling.

Responsibilities

Perform patient registration:

Interpret and explain various forms to meet privacy and regulatory requirement. Obtain the appropriate signatures on all require documents.

Inform patients of hospital policies such as filing of insurance, room assignments, room charges, discharge time, consent to treatment, advance directives and other regulatory requirements.

Prepare electronic financial folders to include all information pertinent to billing i.e. pre-certifications documents, benefits information, insurance card copies and signed registration documents.

Operate office machines; correct minor equipment failures of office machines and contact vendors when necessary to fix major equipment failures.

Review physician orders for coding and routing purposes.

Provide insurance benefits interpretation and counseling.

Provide insurance benefits interpretation and counseling based on the information provided either via the electronic eligibility function or the manual process. Coverage is explained to the patient to include notification of any deductibles or co-pays. Payments are received after services are rendered. The pre-certification process is explained and information is verified with the patient and or representative.
Maintain medical terminology skills and knowledge of third party payer regulations.

Maintain skill set through daily use of appropriate medical terminology and application of regulations. Knowledge also supported by updates posted in regulatory bulletins, hospital publications and insurance contracts.

Supply and/or work data quality/statistical reports.

Monitor registrations for completeness and accuracy.

Maintain and submit daily registration activity logs.
Monitor forms for appropriate signatures and completeness.

Perform patient and customer relations.

Greet patients and visitors in a professional manner to determine service needs.

Direct and/or transport patients to the appropriate service areas.

Coordinate care with the appropriate clinical staff to insure patient evaluation prior to registration when applicable.

Communicate the status of the patient throughout the admission process to the patient and or representative.

Coordinate services with other healthcare providers when necessary i.e. Social Workers, Chaplains, Patient Representatives, Patient Coordinators, etc.

Conduct service recovery efforts when applicable.
Complete other duties as assigned.

Cross train to perform other duties within Patient Access Services.

Maintain productivity reports.

Participate in special projects.

Minimum Requirements

High School plus less than 1 year of formal training or education
1 - 2 years experience in a hospital, physician office, public health agency, insurance company, co-op or internship.
Substitution for education and experience year-for-year.