Patient Access Rep II

JOB DESCRIPTION: A Patient Access Rep II will assist in the coordination prioritization and completion of front-end patient registration activities ranging from pre-registration through discharge in the Patient Access Services Department. The representative will ensure patient insurance verification is accomplished and all requirements are met. Accurately completes patient registrations based on departmental protocols and standards policies and procedures and compliance with regulatory agencies. Calls patients to pre-register or confirm appointments. A Patient Access Rep II prioritizes work for optimal reimbursement and to avoid financial risk to both patient and hospital.

Ensures all insurance requirements are met prior to or on the date of service and informs patients of their financial liability and collects liability due. Identifies patients who require early financial counseling intervention. Ensures all uninsured patients are referred to a financial counselor as appropriate.

A Patient Access Rep II will also assist patients guarantors and families with insurance questions in a professional manner and is responsible for escalating any unaddressed insurance benefit concerns to the department Financial Counselor. Maintains confidentiality of patient information employee information and other information covered by regulations or professional ethics. Performs duties in support of the EHC Patient Access Mission Statement. Position requires self-motivated individual with demonstrated ability in time management who can handle high patient volumes and fast pace.

Maintains thorough understanding of insurance registration scheduling referrals authorizations and account follow-up. Maintains knowledge of multiple department system applications utilized by Patient Access. Familiar with and adheres to all state and federal regulations such as EMTALA CMS HIPAA and JCAHO guidelines.

Effectively communicates identified issues and concerns in a constructive and professional manner. Participates in generating ideas and solutions for improvements. Responds in a timely and appropriate way to verbal and written requests. Accurately searches the database to establish if patient is new or an established patient. Obtains required signature for release of information in a timely manner adhering to policy and procedures.

Completes registration by verification of information and insurance for established patient or entering information for new patient prior to discharge of patient. Reconfirms date of birth and legal spelling of the patients name. Obtains appropriate signature(s) and scans all appropriate documents (Admission/Registration Agreement Notice of Privacy Practice and Important Message from Medicare etc.).
Scans patient id and insurance cards. Makes every attempt to collect patient liability as appropriate and documents the response if not collected. Appropriately distributes registration paperwork according to departmental procedures. Schedules procedures/follow-up appointments. Communicates hospitals financial policies to all patients. Call patients to pre-register or confirm appointments. Maintains appropriate monthly assurance accuracy rate as determined by the department. Maintains established departmental standards regarding productivity quality and collections.



MINIMUM QUALIFICATIONS: High school diploma or equivalent. Must have at least 2 years healthcare related or customer service experience.
Knowledge of Medicare Medicaid and other commercial payers (HMO PPO) preferred. Associate or bachelor degree may be accepted in lieu of experience. Certified Healthcare Access Associate (CHAA) preferred.
Typing skills with a minimum of 35 wpm and good communication skills.



PHYSICAL REQUIREMENTS (Medium Max 25lbs): up to 25 lbs 0-33% of the work day (occasionally); 11-25 lbs 34-66% of the workday (frequently); 01-10 lbs 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking Occasional sitting Close eye work (computers typing reading writing) Physical demands may vary depending on assigned work area and work tasks.



ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock Floor Surfaces Hot/Cold Temperatures Indoor/Outdoor conditions Latex Lighting Patient care/handling injuries Radiation Shift work Travel may be required. Use of personal protective equipment including respirators environmental conditions may vary depending on assigned work area and work tasks.