Patient Access Representative .5

SSM Health - Madison, WI (30+ days ago)3.8


Role Purpose:
The Patient Access Representative is responsible for assisting patients during the onsite registration and arrival processes for scheduled and unscheduled visits. The Representative in this role must have excellent customer service skills and the ability to manage multiple tasks simultaneously and adjust to issues as needed in a dynamic work environment. This employee completes the patient access process for inpatients and outpatients, takes demographic, reviews insurance and medical information, ensures managed care requirements are met, collecting patient liabilities when necessary and complies with regulatory guidelines.

Activate patients in the patient management system upon arrival on the date of service and assist patients and customers in navigating throughout the hospital facility.
Obtain and enter demographic and other financial and clinical information necessary for financial clearance of scheduled/unscheduled accounts.
Responsible for understanding eligibility responses from insurances to assist patients in understanding their insurance benefits; copay, deductible, coinsurance.
Verify that there is a complete physician order in place at time of service.
Ensures that all necessary documents, including consents, insurance card copies, photo IDs, and other documents as deemed necessary are scanned into the patient business cycle system and obtain all necessary patient signatures at time of arrival.
Collect remaining patient liability responsibilities that were identified during financial clearance or RTE review, and offer prompt pay to all patients on date of service or before discharge for admitted patients (with the exception of WI region).
Assist patients with onsite customer service functions (e.g., billing, medical record, and collection inquiries) by coordinating with other patient business services functions and departments such as Financial Counseling. The ability to perform collections and cashiering functions when necessary.


Minimum Qualifications:
Requires High School diploma
3 to 12 months of experience

Preferred Qualifications:
Medical terminology
St. Mary's Hospital – Madison –
St. Mary's is a 440-bed tertiary referral hospital offering inpatient and outpatient treatment and diagnostic services in primary care and nearly all specialties. Medical/surgical areas of special focus include the Family Birth Center, pediatrics, Neuroscience Center, geriatrics, orthopedics, emergency services and more. St. Mary's is affiliated with the University of Wisconsin School of Medicine's three-year family practice residency program. Since 1912, St. Mary's has provided service to much of south-central Wisconsin including Dane County and 17 other nearby counties. In the growing city of Sun Prairie, northeast of Madison, St. Mary's Emergency Clinic provides services to more than 30,000 residents.