Patient Access / Pre-Access Representatives facilitate a welcome and easy access to the facility and are responsible for establishing an encounter for any patient who meets the guidelines for hospital service. Patient Access / Pre-Access staff ensures that all data entry is accurate including demographic and financial information for each account. Patient Access / Pre-Access has numerous procedural requirements including data elements, insurance verification, authorization for services, collections for all patient portions including prior balances and balancing of cash at shift end. Patient Access / Pre-Access staff is responsible for the successful financial outcome of all patient services. Patient Access / Pre-Access communicate directly with patients and families, physicians, nurses, insurance companies and third party payers. This position requires professional appearance, behavior, and good communication skills. Patient Access / Pre-Access representatives require dependability, flexibility, and teamwork.
Action Oriented -- Taking on new opportunities and tough challenges with a sense of urgency, high energy and enthusiasm.
Customer Focus -- Building strong customer relationships and delivering customer-centric solutions.
Communicates Effectively -- Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences.
Decision Quality -- Making good and timely decisions that keep the organization moving forward.
Collaborates -- Building partnerships and working collaboratively with others to meet shared objectives.
Nimble Learning -- Actively learning through experimentation when tackling new problems, using both successes and failures as learning fodder.
Demonstrates Self-Awareness -- Using a combination of feedback and reflection to gain productive insight into personal strengths and weaknesses.
Goals -- Completes quarterly goals
Delivering the Mission -- Performs duties as defined in this job description and demonstrates mastery of role
* REGISTRATION / SCHEDULING
* Obtains and accurately inputs all required data elements for scheduling and registration, including patient demographic, financial information, guarantor information, and relevant notes associated with the encounter.
- Data fields include but are not limited to address, employment, insurance info, nearest relative, guarantor, insurance plan, admitting diagnosis, and physician information.
* Prioritizes and completes registrations / scheduling in a consistent, courteous, professional, accurate and timely manner. * Ensures each patient is assigned only one medical record number. * Selects appropriate patient type based on the department and services required. * Communicates the purpose of and obtains patient/legal guardian signatures on all necessary hospital documents. Knowledgeable of all such documents.
* Hospital care consent * Notice of Visit * Health Information Exchange (HIE) * Important Message from Medicare (IMM) * Medicare Outpatient Observation Notice (MOON) * Financial Assistance Application * Notice of Privacy Practices * Patient Rights * Documents in account notes.
* Insurance Verification / Explanation of Benefits
* Verifies eligibility and obtains necessary authorizations for services rendered.
* Utilizes online tools to verify insurance benefits, run medical necessity, determine estimate for services and process upfront collections. * Answer Medicare Secondary Payor Questionnaire. * Demonstrates accuracy in selecting insurance plans (I-plans).
* Knowledge and ability to review notes on all pre-admitted accounts and discuss with customer in a courteous professional manner
- Knowledge and ability to review and explain previous accounts
- Demonstrates contribution and achievement of department collection initiatives.
* CUSTOMER FOCUS
* Effectively meets customer needs, builds productive customer relationships, and takes responsibility for customer satisfaction and loyalty. * Greets patients in a courteous and professional manner. * Calls patients by name. * Asks patients if they may have special needs. * Represents the Patient Access / Pre-Access department in a professional, courteous manner at
* Reviews Accureg daily to ensure a 99% accuracy rate. * Requests additional education information when necessary.
One year experience in hospital registration or a comparable position preferred