Patient Access Representative - Full-Time - AVALA Hospital - RH332

Summary

Under thesupervision of the Director Financial Services the Patient AccessRepresentative is responsible for obtaining accurate patient demographics andinsurance information during the patient interview process; the processincludes inperson and phone interviews corrects information as the registration including obtaining the patients signature on theAuthorization for Treatment Advanced Beneficiary Notice (ABN) and completingthe Medicare Secondary Payer (MSP) questionnaire. Scans all necessarydocumentation into Patient Account. Performs verification of benefits and fullyunderstands plan benefits. Collects copayments estimated coinsurance anddeductibles which includes phone calls to physician offices to discussfinancial authorization status prior to service as well as collecting at timeof service. Answers incoming phone calls and assist caller as needed. And anyother duties assigned by the Director Revenue Cycle.

Essential Duties and Responsibilities

Registration andVerification

• Ableto handle heavy phone volumes ensures that callers are transferred to theappropriate department and/or person. Answers calls in a timely manner;identifies department and self when answering the telephone. Able to handle allcodes and stat calls proficiently.
• Verifiesthat patient demographic information is accurate and ensures that insurancecards consents and other admission documents are complete and in order.
• Abilityto explain required forms to the patient in detail (i.e.: Authorization forTreatment Advanced Beneficiary Notice (ABN) and Medicare Secondary Payer(MSP) questionnaire). Obtains required signatures as needed.
• Aspart of the preregistration process contacts patient to verify demographicinformation insurance information and MSP questionnaire.
• Abilityto verify insurance coverage and understand benefit requirements and ensuresthat all notification/authorizations are completed based on plan requirements.
• Workwith physician offices to obtain necessary authorization on scheduledprocedures.
• Abilityto explain insurance benefits to patient.
• Informspatients of estimated balance due based on plan benefits and collects moniesdue at time of service.
• Demonstratesknowledge of all features and functions of the Patient Accounting areas.
• Notifiesappropriate staff regarding any issues or concerns in a timely manner.
• Balancesdaily receipts list to cash checks and credit card payments received at theend of each day.
• Communicateswith management/physician offices regarding any problematic insurance concernsthat may affect the payment of services.

Other Duties

• Functionsas back up to concierge.
• Otherduties as assigned.

Core Competencies

ActionOrientation Targets and achieves results overcomes obstacles acceptsresponsibility establishes standards and responsibilities creates aresultsoriented environment and follows through on actions.

Communications Communicates well both verbally and in writing. Effectively conveys andshares information and ideas with others. Listens carefully and understandsvarious viewpoints. Presents ideas clearly and concisely and understandsrelevant detail in presented information.

Creativity/Innovation Generates novel ideas and develops or improves existing and new systems thatchallenge the status quo takes risks and encourages innovation.

CriticalJudgment Possesses the ability to define issues and focus on achievingworkable solutions. Consistently does the right thing by performing withreliability.

CustomerOrientation Listens to customers builds customer confidence increasescustomer satisfaction ensures commitments are met sets appropriate customerexpectations and responds to customer needs.

InterpersonalSkills Effectively and productively engages with others and establishestrust credibility and confidence with others.

Leadership Motivates empowers inspires collaborates with and encourages consensus when appropriate. Focuses team members on common goals.

Teamwork Knows when and how to attract develop reward and utilize teams to optimizeresults. Acts to build trust inspire enthusiasm encourage others and helpresolve conflicts and develop consensus in creating highperformance teams.

Professional Requirements

• Meets dress code standards and adheres topolicies.
• Completes annual education requirements.
• Maintains regulatory requirements.
• Maintains patient confidentiality at all times.
• Reports to work on time and as scheduledcompletes work within designated time.
• Wears identification while on duty usescomputerized punch time system correctly.
• Completes inservices and returns in a timelyfashion.
• Attends annual review and departmentinservices as scheduled.
• Attends staff meetings or reads and returns allmonthly staff meeting minutes.
• Represents the organization in a positive andprofessional manner.
• Actively participates in performance improvementand continuous quality improvement (CQI) activities.
• Complies with all organizational policiesregarding ethical business practices.
• Communicates the mission ethics and goals ofthe hospital as well as the focus statement of the department.
• Assists other staff members in performing anyduty that enhances the delivery of patient care.

Regulatory Requirements

• High school diploma.
• Two 2 or more years experience.

Skills

• Ability to communicate effectively in Englishboth verbally and in writing.
• Basiccomputer knowledge.

Physical Demands

The physicaldemands described here are representative of those that must be met by anemployee to successfully perform the essential functions of this job. Whileperforming the duties of this job the employee is regularly required to talkand hear. This position is very active and requires repetitive motions standingwalking bending kneeling and stooping all day. The employee must frequentlylift or move items weighing up to 20 pounds.