Patient Access Representative (Medical Office Building)

Description

JOB SUMMARY

Under the general direction of the Practice Manager and the Executive Director of Physician Practice, the Patient Access Representative will provide assistance to non-emergent patients as well as perform the registration for patients presenting for services, maintain documentation, verify insurance, accept payments, in accordance with The Joint Commission, federal, state, and local guidelines, organizational and departmental policies and procedures. Communication with medical staff, other departments, and outside agencies while maintaining confidentiality is required. Position requires self-motivation, creativity, and capabilities to function in a semi-autonomous role within a fast-paced and dynamic environment.

STANDARDS OF PERFORMANCE

1. Performs registration for all patients presenting for service.
2. Obtains, inputs, and transcribes accurate patient data.
3. Completes necessary forms including proper documentation/signatures, insurance information, either on paper or on scanner.
4. Enters data into the computer with minimal errors.
5. Performs as a cashier for payments and maintains cash receipts with accuracy.
6. Meets non-emergent patients to discuss treatment options and financial options.
7. Assesses insurance status. Verifies insurance benefits. Calculates and collects appropriate deductibles and/or co-insurance from patients on services rendered or to be rendered.
8. Obtain payment of applicable co-payments and/or deductibles according to health plans.
9. Discusses with uninsured patients their financial obligations and referral options as per policy.
10. Will navigate through the Availity or Ability software systems to obtain patient’s financial responsibility.
11. Sets up financial agreement according to hospital guidelines for any balance due.
12. Explains Helping Hands program option, if applicable.
13. Scan of all records into electronic medical records.
14. Provides Advance Directives information to all patients as per hospital policy/procedure.
15. Act as an ambassador for the facility by interacting with clients, family members, and staff in a friendly caring manner.
16. Requires completion of Insurance Billing Specialist and Insurance Billing Certification course with Hometown Health.
17. Ensures adherence to proper infection control, OSHA and safety standards.
18. Performs other duties as assigned/needed/required.
19. Provides support for other team members when needed.

Requirements

Minimum Level of Education: Education level equivalent to completion of High School is required. Completion of a Patient Access or Financial Services-specific to Healthcare curriculum or equivalent is highly preferred.

Formal Training: None Required.

Licensure, Certification, Registration: None Required. Will be required to attain Hometown Health Certification in Financial Counseling by the 90-day review.

Work Experience: Working knowledge of health insurance, deductibles, co-pays, and co-insurance required. Minimum of twenty-four months (2 years) experience in customer service, patient registration, and collections preferred. The job requires a comfort level without of pocket collections activities, as well as a thorough understanding of the accuracy needed for the capture of demographic and third-party payer information.