Representative Patient Access L1

POSITION SUMMARYThe Patient Access Representative verifies demographic and insurance information completes coordination of benefit changes calculates patient estimates verifies the accuracy of the surgery prior authorization and collects patient financial obligations. The individual utilizes a complex skill set and verifies every scheduled patient surgery and is ultimately responsible for assisting patients and families. Works as a member of a team to ensure reimbursement for services in a timely and accurate FUNCTIONSConfirm valid coverage for services and location by contacting insurance companies and/or review electronic responses for benefit informationManage patient insurance demographic information to verify authorization that service is a covered benefit based on knowledge of the specific insurance plan the specific benefit package restrictions and the timing of the serviceUnderstand patient deductibles out of network referrals and out of pocket the account and timing of last patient demographic query to identify missing standard and/or required information. If necessary contact the patient to complete the and collect patient liability before or at the time of service. Communicate the liability and explain the calculation low and high amounts when the potential need for assistance when the coverage/benefit is either inadequate or nonexistent for a medically necessary service and if necessary create a payment plan with the patient and document the agreement automated call center calls and determine whether an outbound call is necessary either to the patient or to the insurance company. For a call back assess the call and respond appropriately attempting to resolve all patient inquiriesBuilds strong working relationships with assigned business units hospital departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to these internal to incoming calls and makes outbound calls as required to resolve billing payment and accounting issues. Provides assistance and excellent customer service to patients patient families providers and other internal and external customersPerforms all functions according to established policies procedures regulatory and accreditation requirements as well as applicable professional standards. Provides all customers with an excellent service experience by consistently demonstrating our core and leader behaviors each and every : The essential functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbents immediate QUALIFICATIONSHigh school diploma /GED or equivalent working knowledge of one or more of the following: patient financial services or collecting service processes normally acquired over up to two years of work the ability to manage multiple tasks simultaneously with minimal supervision and to work strong interpersonal oral and written communication skills to effectively interact with a wide range of knowledge in the use of common office software word processing spreadsheet and database software are QUALIFICATIONSWork experience with the Companys systems and processes is preferred. Previous cash collections experience is preferred. Additional related education and/or experience DEMANDS/ENVIRONMENT FACTORSOE - Typical Office Environment: (Accountant Administrative Assistant Consultant Program Manager)Requires extensive sitting with periodic standing and be required to lift up to 20 significant use of personal computer phone and general office adequate visual acuity ability to grasp and handle ability to communicate effectively through reading writing and speaking in person or on require off-site travelSUPERVISORY RESPONSIBILITIES NoneDIRECTLY REPORTINGReports to the Supervisor Patient AccessTYPE OF SUPERVISORY RESPONSIBILITIESN/ASCOPE AND COMPLEXITYWorksindependently under general supervision following defined standards and procedures. Reports to a Supervisor or Manager. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner. External customers include all ambulatory surgery center patients patient families and all third-party payers. Internal customers include facility medical records and patient financial services staff attorneys and central services staff members.