Patient Access Representative (Non-Exempt)- PT, Varies / Rotating, Holidays, Weekends

Patient Access Representative

The Patient Access Representative is often the first point of contact for our patients and therefore must represent Mercy with the highest standard of customer service, compassion and perform all duties in a manner consistent with our mission, values and Mercy Service Standards. The Patient Access Representative will facilitate all components of the patient's entrance into any Mercy facility. This may include scheduling, registration, benefit verification, pre-certification and financial clearance including pre-visit collection. The Patient Access Representative will be responsible for ensuring that the most accurate patient data is obtained and populated into the patient record. This co-worker must have an exceptional attention to detail and maintain knowledge and competence with insurance carriers, Medicare guidelines as well as federal, state and accreditation agencies.

Job Description :

• Mercy Service
• Greets every individual on the phone or in person with a smile and a warm, professional greeting.
• Provides outstanding customer service to all internal and external customers including our patients, visitors, co-workers, physicians, and insurance companies.
• Keeps all wait times to a minimum.
• Communication
• Works effectively with other co-workers, clinical departments and clinics to accomplish work and departmental projects.
• Demonstrates positive and professional communication skills.
• Exhibits objectivity and openness to others views, contributes to building a positive team spirit.
• Confidentiality
• Respects at all times the confidentiality of patient records and uses complete discretion when discussing patient matters.
• Ensures all patient information is secured and all paperwork is disposed of in appropriate confidential trash receptacles.
• Stewardship
• Ensures all out of pocket financial responsibility is documented on all encounters and communicated as appropriate.
• All out of pocket financial responsibility is requested prior to and / or at the time of service.
• Refers patients for financial assistance or to the Medicaid Eligibility team when appropriate.
• Accurately posts patient payments and balances cash drawer as per departmental policy.
• Change Management
• Demonstrates an open attitude toward change and participates in the change process.
• Handles variance in job duties, making necessary adaptations.
• Follows instructions, responds to management direction.
• Quality
• Ensures the highest level of accuracy and thoroughness of registration information including demographics and insurance information.
• Accurately identifies patient record using a minimum of two patient identifiers (name, DOB, SSN).
• Ensures that appointments are scheduled accurately and all required directions are communicated to the patient.
• Referrals are accurately completed including all required smart phrases.
• Follows all policies and procedures pertaining to insurance verification, eligibility, appropriate pre-certification requirements.
• Compliance
• Obtains all required data to meet various Health System standards and regulatory requirements (e.g. Joint Commission, Medicare Compliance, EMTALA, HIPAA, etc.)
• Obtains legal signatures on appropriate insurance, consent, and financial forms.
• Obtains all required clinical information including paper requisitions as needed.
• Proficiency and Initiative
• Demonstrates knowledge of the necessary computer applications.
• Knowledgeable of computer down time procedures, notifying all parties involved, and utilizing manual processes as appropriate.
• Participates in professional continuing education opportunities.
• Volunteers readily, actively seeks new knowledge and skills for personal and job development.
• Takes responsibility for own actions and commits to doing the best job possible.
• Meets established patient processing goals and revenue cycle goals.

Qualifications :

Experience and Education Requirements : 1-3 years clerical experience and customer service experience preferred. Experience with medical terminology and insurance plans preferred. High School diploma required; some college helpful.

Minimum skills, knowledge and ability requirements :

Physical Requirements :

We Offer Great Benefits :

Day-one comprehensive health, vision and dental coverage, PTO, tuition reimbursement and employer-matched retirement funds are just a few of the great benefits offered to eligible co-workers, including those working 32 hours or more per pay period!