Job Summary: Under the direction of the PAS manager, the Patient Access Representative is responsible for assisting patients during the on-site registration and arrival process for scheduled and unscheduled visits as well as completing financial clearance functions. This individual completes the registration for unscheduled visits by collecting accurate demographic information, insurance information, and collecting patient liability (if known) at the time of service. This individual is also responsible for financial clearance functions on assigned scheduled accounts during registration downtimes. In addition, this individual is responsible for miscellaneous client service activities including valuables collection and providing basic customer service. The Patient Access Representative greets and serves patients in a professional, friendly, and respectful manner to promote positive encounters.
1. Perform full duties and task of an Associate Patient Access Representative.
2. Assist patients with the financial assistance process to include screening.
3. Read and understand patients insurance, eligibility and benefits.
4. Understand the Authorization Policy and works with leadership and physician’s office to determine if the patient’s procedure is urgent/emergent for possible service deferral.
5. Sends notifications to insurance companies on inpatient and observation patients and communicates with Case Management if clinicals are required and documents in Meditech notes.
6. Confirm all procedures have required authorizations.
7. Calculates patients liability, provides estimates, collect patient portion and perform cashiering functions.
8. Obtain all information necessary to perform benefits verification for unscheduled visits.
9. Coordinate with bed placement and ensure appropriate patient type and status changes are performed in a timely manner.
10. Assist patients with on site customer service functions (e.g., billing, medical records and collection inquires)
11. Ability to close cash drawers and make deposits.
12. Act as a knowledgeable resource on Patient Access for department staff. (e.g., answer questions, assist with new hires)
13. Review own work for accuracy and completeness prior to end of shift
14. Adhere to state and federal regulations
15. Meet productivity, point of service collections, and quality goals/standards.
16. Perform other duties as assigned
1. Knowledge on navigation of Health Plan Websites
2. Knowledge of billing codes (DRG, ICD-9, ICD-10, CPT and HCPCS codes)
3. Knowledge of medical insurance and the different types of payer benefits
Minimum Position Qualifications:
Experience: A minimum of 3 years healthcare experience within Patient Access of Business office setting.
Previous experience with insurance eligibility systems.
Utilization of medical terminology in job setting.
Knowledge in medical billing codes
Preferred Position Qualifications:
1. High school diploma or GED preferred.
2. 5 years registration experience preferred.
3. Associates Degree in Healthcare or Business Administration.