Patient Access Outpatient Representative - PRN - Shifts Vary

Job Category: Revenue Cycle

Work Shift/

Schedule:

Varies

About the Role: Job Summary — Under the supervision of The Patient Access Supervisor, this position is responsible for ensuring the delivery of outstanding customer service while greeting patient, registering patient and verifying or obtaining complete and accurate patient demographic information, identifying patient benefits eligibility, verification of pre-certification obtained from insurance companies and/or physicians offices, identifying insurance and/or patient responsibility, collecting identified co-pay/deductible, co-insurance, and/or providing financial counseling when appropriate, and completing the entire registration process.

• Licensure or other certifications:
• Educational Requirements:
  
  High School Diploma or GED
• Minimum Experience:
  
  Must be able to type 35-45 wpm. Proficient in the use of office equipment (computer, fax, telephone, scanning copier). Must be mobile and push patient in wheelchair, if necessary between any location within hospital campus.
• Other:

• Preferred Licensure or other certifications:
  Bilingual preferred
• Preferred
  
  Educational Requirements:
  
  Associate or Bachelors Degree in Business, Financial/Health Care related field.
• Preferred Experience:
  
  Medical terminology, data entry and computer experience, admitting, business office, collection, physician office experience and working with public preferred.
• Other:

• Ability to work independently, emotionally mature and able to function effectively under stress while continuing to demonstrate positive attitude with patients at all times
• Excellent problem solving and analytical skills
• Working knowledge of Protected Health Information
• Ability to be flexible and manage change. Excellent written and oral communication skills required.
• Must be proficient with use of all Patient Access Systems, Software Application and Processes
• Must be able to demonstrate knowledge of billing requirements and proper documentation of
• Must possess detailed understanding and knowledge of insurance guidelines and protocols, the components of full verification, and payor information / requirements

• Responsible for capturing and documenting all pertinent patient demographic, subscriber, and insurance information i.e.; patient Policy and , subscriber, guarantor, payor address, phone number, and contact information. Documentation must include, effective date, copay, deductible, out of pocket, co-insurance, and stop loss amounts, percentage of coverage and any other pertinent information concerning the specific visit into the EHR system.
• Obtains complete and accurate insurance information; completes insurance verification by contacting patients, physician offices and insurance/payer regarding the visit; verifies patient’s insurance eligibility and benefits with the information obtained.
• Reviews work and assures accuracy in all aspects of the position; particularly patient type, visit type, code identification, insurance information, and demographic information to minimize error rate and time delays in other areas.
• Responsible for assessing and collecting financial liabilities prior to service when applicable; educates patients on billing process for the facility; refers patients for financial counseling if applicable; documents payment information in system as appropriate.
• Scans appropriate data into Document Management System (including, but not limited to; insurance cards, drivers license, physician orders, consent forms, and any other registration related documents pertinent to the patient's medical record).
• Identify patient's history in all Patient Access Systems to avoid duplication of medical records.
• Responsible for confirming and updating EHR system with pre-certification information for all scheduled and non-scheduled outpatient accounts as applicable.
• Performs medical necessity checks on all appointments in which it is applicable; completes ABN form upon any failure to meet medical necessity.
• Obtains and accurately completes MSP forms when applicable.
• Demonstrates ability to…