Patient Access Representative (Per Diem/CPT)

Category:

Administrative/Clerical

Description:

The Patient Access Representative interviews patients to obtain necessary information, prepare admitting/registration forms, gather insurance information and perform other clerical/computer operational tasks related to the admitting of inpatients and outpatients coming into the facility at 90% accuracy. If a patient presents for an outpatient service that is typically a scheduled service, routes the patient to the Scheduling Representative.

Minimum qualifications:

• High school diploma or GED equivalent, preferred.
• One year computer training and/or experience.
• Medical insurance and/or hospital registration experience preferred.

Primary Responsibilities:

• Is responsible for accurate registration of all patients' while maintaining regulatory and functional knowledge of all information required to register patient types in database which ensures timely & accurate reporting/billing.
• Gathers related information from various sources to produce completed chart and prepare patient for any service requested by physician.
• Is responsible for distribution of patient related materials and maintaining patient or designee's signature on all necessary consents, permits, financial forms, advanced beneficiary notices, Important Message from Medicare, as well as charity application, when applicable.
• Inputs patient information into computer to produce medical record patients' labels, bracelets, face sheets and important message from Medicare as appropriate. Scans at time of registration all insurance cards, state ID, and other signed registration forms such as Notice of Privacy, Permissions and Acknowledgments, consent for treatment, etc., as required.
• Is responsible for collection of patients owed copay's as well as referring patient to financial assistance department, when applicable. End of day cash out procedure applies.
• Is responsible for utilizing insurance verification tools to accurately verify patients' insurance for patient walk-in services.
• Ensures the patient record is updated with accurate information, and the insurance record reflects all appropriate insurance(s), appropriately prioritized in coordination with the information provided by the Verification/Authorization Representatives. (coordination of benefits)
• Is responsible for notifying the servicing department and the Verification/Authorization Representative when a patient checks in for a scheduled service with insurance information that is different from what was verified previously.
• Is responsible for notifying insurance companies that a member has been admitted to the Emergency Room, as an inpatient or an outpatient as appropriate by their insurance plan.
• Has an understanding and working knowledge of medical insurance benefits, Medicaid and Medicare regulatory requirements.
• Ensures all self-pay accounts are checked for Medicaid eligibility, and all Medicare primary patient accounts are checked for Medicaid eligibility when there is no secondary coverage for walk-in services.
• Coordinates with Nursing Services/Designee the efficient use of available beds, including inpatient, observation and skilled, while adhering to appropriate registration standard and notifies Verification/Authorization Representative II of the admission.
• Functions as a switchboard operator during shift. Responsibilities shall include but not be limited to, answer and route all incoming/inside telephone calls and direct public to appropriate area, and coordinate "codes", as applicable.
• Has strong attention to detail and demonstrates ability to use sound judgment in decision making.
• Understands and demonstrates the importance of satisfying the needs of the patient/customer by interacting with him/her in a friendly and caring way. Being attentive to the customer's needs, both psychologically and physically, by taking the initiative to maintain communication with the customer, assign payment accurately and ensure appropriate insurance notifications are done in order to provide a secure and pleasant experience throughout the patients' visit.
• Assists in the daily audit of all registered patients checking for accuracy and notifies original registration clerk of possible or necessary changes/updates when time permits.
• This job description lists typical duties for the classification and is not to be considered inclusive of all duties that may be assigned. Employee accepts and performs other duties as assigned.
• Employee is required to comply with all then-current and future policies and procedures and reports directly to the Patient Access Manager.

Standard for portrayal of mission and values:

• Employee demonstrates and fosters the Lewis County Hospital District No. 1 core values of - One team, on Mission. Go out of your way, to brighten someone's day. Own it, embrace it. Care like crazy. Motivate, elevate, appreciate. Know the way, show the way, ease the way. Find joy along the way.
• Employee demonstrates and fosters the mission of Lewis County Hospital District No. 1 to foster trust and nurture a healthy community.
• Is cooperative and supportive to others within the department and hospital providing care and services.
• Treats individuals including patients, co-workers, supervisors, management, patient families, physicians, volunteers, visitors, and others with respect, dignity, and fairness.
• Behaves professionally and ethically in all interactions with patients, co-workers, supervisors, management, patients' families, physicians' volunteers, and others.
• Is consistently courteous to patients, co-workers, supervisors, management, patient’s families, physicians, volunteers, and others; greets individuals and provides assistance and direction in an attentive and helpful manner.
• Willingly strives at continuous quality improvement to achieve quality work the first time every time.
• Is willing to learn new procedures and develop new skills for the purpose of improving quality of care and services.
• Willingly participates as a member of the work team(s) supporting the goals and objectives of the department and the district.
• When answering the telephone, is courteous to the caller, clearly identifies department, name and takes a message or directs calls as necessary in a helpful manner.

Benefits Include:

Additional 15% (on base wage) in lieu of benefits and Sick leave accrual (.025/hr.)