DESCRIPTION OF POSITION:

• The patient access representative registers, schedules, and performs related processing duties for all patients being served by respective clinic. Duties are done in Practice Management and EMR system as appropriate. As a member of the clinic team the patient access representative is trained in performing a wide range of skilled administrative and clerical duties. Reports to the Office/Practice Manager

RESPONSIBILITIES AND DUTIES:

• Manage all inbound and outbound customer calls in a timely manner
• Accurately evaluates each account in order to determine what is needed, what is left outstanding and what steps are necessary to resolve the account in both patient Practice Management System
• Answers phones with correct salutation and professionalism
• Strong phone and verbal communication skills along with active listening
• De-escalate situations involving dissatisfied customers, offering patient assistance and support
• Communicates effectively with all patients regarding their current account status and explaining of insurance benefits related to Deductibles, Co-Insurance and Co-payments
• Follows appropriate payment guidelines. Approaching patients for Payment in full, Payment Plans and Future Payment information as appropriate per the call
• Obtain financial information from patients/guarantors to determine free care eligibility
• Verify insurance, eligibility, and obtained authorizations when required
• Manage insurance changes and requirements
• Ensure current carrier information is maintained in Patient Account System
• Monitor accurateness, suitability and totality of patient accounts
• Followed up on accounts with outstanding balances in appropriate manner
• Document all calls, correspondence, and related activities to each patient's account
• Remained compliant with HIPPA guidelines and maintains the strictest confidential practice when dealing with patients' personal and financial information
• Demonstrated capacity to work under pressure and ability to multitask at all times on many different levels
• Maintains assigned task by ensuring that the task is completed timely
• Research returned mail; update patient demographics accordingly
• Understands Statement paths, next follow up dates and updates appropriately to maximize collection potential
• Understands UCC, MVA, Bankruptcy, Deceased and all Patient Account patient processes in order to properly offer assistance to patients
• Performs other duties as assigned to meet the organization's needs
• Supports organizational changes. Demonstrates flexibility in providing coverage and/or availability for the call center for unexpected absences, events, or call volume variance
• Identifies and resolves patient billing complaints
• Performs various collection actions including contacting patients by phone.
• Answer patient and/or insurance phone inquiries; utilize claims software to check status of claim, submission history and eligibility.
• Ability to multi-task, set priorities and manage time effectively

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

EDUCATION AND WORK EXPERIENCE

• High school diploma or equivalent required.
• Knowledge and training in medical terminology, keyboarding, and computer skills preferred.
• Basic skills in Microsoft Office preferred.
• Previous experience preferred in the areas of scheduling.
• Computer literacy, required.
• Broad range of administrative and technical skills in the context of the healthcare environment.
• Impacts activities in other work areas on a frequent basis and contributes in multiple work areas.
• Demonstrates critical thought process and can work independently.
• Make decisions based on departmental policy.
• Provides feedback to assist with decision making process.
• Works well with others.
• Documents detailed information in patient chart.
• Requires listening skills to maintain cooperative associations.

Physical Demands/Work Environment

• Work requires a variety of physical activities, including moving about within and outside of all hospital properties for long periods of time.
• Must be able to respond quickly and effectively to emergency and non-emergent situations.
• May be required to assist in controlling disorderly conduct or combative patients.
• Must be able to exchange accurate information with patient, family, peers and medical personnel.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.