Patient Access Representative - ED

Patient Access Representative 1 - ED (7p-7a) Job Description

The Patient Access Representative 1 - ED (PAR
1) is responsible for accurately registering patients presenting to the Emergency Department, including traumas, stroke patients, disaster response patients, other emergency patients, behavioral health, direct admits to inpatient units, surgery patients, radiology patients, and prisoners. Registration includes validating patient identity, collecting ED-specific screening information, coordinating with ED nurses to ensure patients are triaged in a timely manner, verification of insurance coverage, calculation of and collection of patient co‑insurance/deductibles/co‑pays, determination of in‑network and out‑of‑network status post‑stabilization, and balancing of cash.

In this fast‑paced, high‑stress environment, the PAR1 demonstrates professional/effective communication skills with patients and families, physicians, and nurses. They manage patient and visitor concerns during traumas and disasters. The PAR1 is knowledgeable of and compliant with federal and state regulations related to acute‑care patient registration, with special emphasis on EMTALA regulations and the No Surprises Act. Team members in the ED must be flexible to change and have an ability to adapt and adjust to a constantly changing environment.

Must be able to respond to disaster activation with plans to work on‑site until conclusion of activation.

• Registration
  • Effectively meets customer needs, builds productive customer relationships, and takes responsibility for customer satisfaction and loyalty.
  • Represents the Patient Access department in a professional, courteous manner at all times.
  • Asks patients if they may have special needs, greets patients by name, and ensures courteous interaction.
  • Prioritizes and completes registration in a consistent, courteous, professional, accurate, and timely manner.
  • Accurately identifies patients presenting to the ER without proof of legal identification due to EMTALA regulations.
  • Obtains necessary information from patients, including demographic data, insurance, guarantor, and correctly inputs it into registration software.
  • If the patient is already in the system, finds correct patient record and verifies information in the system.
  • Uses critical‑thinking skills to evaluate each registration situation and provide a customized registration experience.
  • Applies knowledge of federal and state laws (EMTALA, HIPAA, Balanced Billing Act, etc.) to ensure compliant registration.
  • Manages the special needs of patients, family members, and visitors during active traumatic situations and disaster events.
  • Coordinates registration intake of trauma, stroke, and heart alerts to ensure timely triage.
  • Ensures each patient is assigned only one medical record number.
  • Communicates the purpose of and obtains patient/legal guardian signatures on all necessary hospital documents.
  • Extensively documents each encounter in account notes to ensure successful cross‑function communication.
  • Ensures orders are received and are consistent with tests/procedures.
  • Monitors the waiting room, facilitates patient flow, and resolves issues regarding orders or missing/conflicting information to ensure timely and accurate patient registration.
  • Effectively communicates with patients, families, visitors, EMS, RNs, and providers simultaneously.
• Insurance and Benefits Knowledge
  • Demonstrates knowledge of insurance plans and varying payer rules and requirements related to coverage.
  • Verifies eligibility (utilizing online eligibility software tools whenever possible) and obtains necessary authorizations for services rendered.
  • Selects correct insurance plans in the registration software and places them in the correct order (primary versus secondary).
  • Understands required forms (including Medicare Secondary Payer Questionnaire) and can explain them to the patient.
  • Utilizes payment estimator software to calculate patient financial responsibility and verifies accuracy of the output.
  • Determines when patients may be eligible for financial assistance and directs patients to appropriate resources.
• Financial Collections
  • Uses proven customer service…