Patient Access Representative - Cottonwood, United States - Northern Arizona Healthcare Corporation
Description
Overview:
The Patient Access Representative is responsible for the verification and collection of patient demographic and insurance information by direct data entry to the electronic medical record during the scheduling/pre-admit or admission process prior to discharge.
S/he conducts an interview with the patient or authorized representative to secure information specific to requested services; accurately documenting the discussion and other registration/scheduling activities in the encounter.
Responsibilities:
Patient Registration and Scheduling
- Accurate identification of patient for direct data entry of required clinical, demographic, and insurance information to the electronic medical record during registration or for appointment booking of assigned diagnostic procedures.
- Provides general explanation of scheduled procedures and patient instructions that are necessary for conducting diagnostic medical services.
- Ensures system documentation specific to the patient visit is entered and accurately reflects activities related to patient or provider contact, order documentation, insurance verification, financial education, and payment.
- Provides explanation of legal forms and secures signature of patient/authorized party as required for services.
- Demonstrates basic understanding of compliance standards required within a healthcare environment including EMTALA and HIPAA-Privacy Patient Confidentiality regulations.
Insurance Verification
- Accurate identification and selection of insurance carrier in the patient medical record for specified dates of medical services.
- Performs required notifications to ensure insurance authorization for identified medical services, surgical procedures, and inpatient/observation stays are secured and documented.
- Demonstrates basic knowledge of CPT and ICD10 diagnosis coding documentation as required for medical services.
Financial Counseling
- Demonstrates basic knowledge of regulatory or Third Party Payer insurance requirements including Medicare, AHCCCS/Medicaid, Workers Comp and other commercial payers.
- Educates the patient on insurance eligibility, coverage, and availability of medical financial assistance program(s).
- Collects identified patient financial liabilities; performs secured payment entry and deposit/cash reconciliation steps.
Revenue Cycle Support
- Performs PBX Switchboard functions as required for answering and routing of internal/external calls; paging codes and fire alarms; handles department call volumes as assigned to appropriately respond to requests from patients, providers, or other hospital departments.
- Acts as a resource for clinical departments for registration/scheduled services related to data entry of patient account fields, provider order requirements, and questions regarding insurance coverage or financial assistance.
Compliance/Safety
- Responsible for reporting any safetyrelated incident in a timely fashion through the Midas/RDE tool; attends all safetyrelated training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.
- Stays current and complies with state and federal regulations/statutes and company policies that impact the employee's area of responsibility.
- If required for the position, ensures all certifications and/or licenses are uptodate and valid prior to expiration dates.
- Completes all company mandatory modules and required jobspecific training in the specified time frame.
Qualifications:
Education
High School Diploma or GED
- Required
- Preferred
Certification & Licensures
Experience
1 year in a customer service role
- Required
- Preferred
- Preferred
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