Patient Access Representative-ER - Fulltime-varied shifts

Job Description

Position Title: Patient Access Representative Position Code: Pt Access Rp -____

Position Title:

Patient Access Representative. Department:
Patient Access. Safety Sensitive:
Yes.

Reports to:

Patient Access Manager. Exempt Status:
No.

Position Purpose

All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI’s vision to be among the kindest, highest quality health systems in the country.

At the direction of management, completes the registration process for patients. This includes verification of benefits, discharge of patients, collection of copays or payments, balancing of accounts, and general data entry.

• Customer Service and Patient Satisfaction - Provides excellent customer service, contributes to the overall satisfaction of the patient experience, and adheres to the Behavioral Expectations Agreement.
• Promptly fields and/or directs incoming calls; responds to patient and/or staff inquiries.
• Refers patient accounts to financial counselors when further explanation/education is needed (denied authorizations, out-of-pocket liabilities, coverage options, payment plans, etc.).
• Consistently demonstrates a willingness to assist co-workers to support department efficiency and to support positive customer feedback goals.
• Participates in on-going process improvement activities for the team.
• Floats to other work areas, as requested, and regularly works nights, weekends, holidays, and extended hours when needed.

• Registration/Admitting/Discharge of Patients - Demonstrates ability to preregister, register, schedule, reschedule, and discharge patients according to the defined guidelines.
• Enters new patient data and/or verifies patient records are up to date, confirms the completeness of the electronic health record (EHR) and makes changes as necessary.
• Verifies insurance eligibility and benefits within a timeframe determined by KHI.
• Obtains pre-authorizations from third-party payers in accordance with payer requirements, when needed.
• Ensures identified information are complete and scanned into patients’ electronic health record (EHR) (insurance cards, photo ’s, physician orders, and other admission documents).
• Obtains signatures on all required forms.
• Demonstrates ability to manage co-payments, deductibles, allowances, etc. as instructed.

• Patient Processing - Balances daily cash, completes daily cash log, bank deposit slip, and daily reports to Patient Financial Services; utilizes insurance eligibility/audit tools and reports/correct variances within the EMR.
• Quality performance scores must meet defined goals.
• Verifies insurance eligibility and benefits within a timeframe determined by KHI and obtains pre-authorizations from third-party payers in accordance with payer requirements.
• Collects upfront co-pays, deductible and coins keeping deposits on self-pay and high accounts.
• Regularly works nights, weekends, holidays, and extended hours when needed.

• Lead PAR - Meets all PAR requirements. Provides day to day leadership and supervision of PAR team members, trains and orients new hire PARs, and works with Supervisors to provide continuous training of existing staff. Performs QA audits of registrations, works account checks, and responds to account denials. Assists with the scheduling of staff to ensure appropriate coverage. Participates in the interviews for hiring new staff within the unit, as well as providing feedback to the PAR supervisors for performance evaluations.
  
  Identifies, supports, and manages process improvement initiatives for the team. Collaborates with management to assist in the day-to-day operations of the team.

• Demonstrates ability to multitask, prioritize appropriately, and manage time efficiently.
• Effective oral and interpersonal communication skills.
• Demonstrates ability to utilize a variety of technological resources (phone, computer hardware, various software programs, fax, scanner).

Education:

High School Diploma or equivalent

• PAR:
  Minimum of 1 year of experience working in a customer service position and/or office setting
• Lead PAR:
  Minimum of 1 year of registration or billing experience in a…