The Patient Access Representative is responsible for the verification and collection of patient demographic and insurance information by direct data entry to the electronic medical record during the scheduling/pre-admit or admission process prior to discharge. S/he conducts an interview with the patient or authorized representative to secure information specific to requested services; accurately documenting the discussion and other registration/scheduling activities in the encounter. |
Patient Registration and Scheduling * Demonstrates ability to navigate web-based products or system applications required for registration or scheduling. * Accurate identification of patient for direct data entry of required clinical, demographic, and insurance information to the electronic medical record during registration or for appointment booking of assigned diagnostic procedures. * Provides general explanation of scheduled procedures and patient instructions that are necessary for conducting diagnostic medical services. * Ensures system documentation specific to the patient visit is entered and accurately reflects activities related to patient or provider contact, order documentation, insurance verification, financial education, and payment. * Provides explanation of legal forms and secures signature of patient/authorized party as required for services. * Demonstrates basic understanding of compliance standards required within a healthcare environment including EMTALA and HIPAA-Privacy Patient Confidentiality regulations. |
Insurance Verification * Accurate identification and selection of insurance carrier in the patient medical record for specified dates of medical services. * Navigation of web-based products or system applications to initiate and document insurance eligibility, benefit details, and authorization requirements. * Performs required notifications to ensure insurance authorization for identified medical services, surgical procedures, and inpatient/observation stays are secured and documented. * Demonstrates basic knowledge of CPT and ICD10 diagnosis coding documentation as required for medical services. |
Financial Counseling * Demonstrates basic knowledge of regulatory or Third Party Payer insurance requirements including Medicare, AHCCCS/Medicaid, Workers Comp and other commercial payers. * Educates the patient on insurance eligibility, coverage, and availability of medical financial assistance program(s). * Collects identified patient financial liabilities; performs secured payment entry and deposit/cash reconciliation steps. |
Revenue Cycle Support * Performs PBX Switchboard functions as required for answering and routing of internal/external calls; paging codes and fire alarms; handles department call volumes as assigned to appropriately respond to requests from patients, providers, or other hospital departments. * Acts as a resource for clinical departments for registration/scheduled services related to data entry of patient account fields, provider order requirements, and questions regarding insurance coverage or financial assistance. |
Compliance/Safety * Responsible for reporting any safety-related incident in a timely fashion through the Midas/RDE tool; attends all safety-related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner. * Stays current and complies with state and federal regulations/statutes and company policies that impact the employee's area of responsibility. * If required for the position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates. * Completes all company mandatory modules and required job-specific training in the specified time frame. |
Education |
Experience |
CALL REQUIRED: Must be able to physically show up |
Yes-within 30 minutes |
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