Acute Patient Access Services Representative

POSITION SUMMARY

This position is the first point of contact at healthcare facilities and assists patients with the administrative aspect of gaining access to medical treatment. This position is in a hospital-based setting which includes Emergency Dept, Inpatient, Obstetrics, Outpatient, etc. Responsible for in person patient intake and registration, providing superior customer service, accurately identifying, and obtaining authorizations patients’ insurance, verifying eligibility and benefits, generating patient estimates for services rendered, financial counseling, and collecting patient liability. Demonstrates the ability to resolve customer issues and provides excellent customer service.

CORE FUNCTIONS

1. Verifies patient’s demographics and accurately inputs this information into EHR, including documenting the account thoroughly to maximize reimbursement and minimize denials/penalties from the payor(s).

2. Proficiency with multiple services including, but not limited to inpatient, observation, emergency, obstetrics, surgery, imaging. This position may cover services 24/7.

3. Demonstrates a thorough understanding of insurance guidelines for all services. Proficiently verifies, reads, and understands insurance benefits.

4. Demonstrates proficient understanding that this position creates the first impression for our patient's experience with Banner Health. Demonstrates a positive patient experience through interactions and effective communication.

5. Proficient understanding of payer authorization guidelines. Accurately submits timely notification according to insurance guidelines using various systems to reduce/eliminate denials. Consistently meets all registration related key performance indicators as determined by management.

6. Obtains federal/state compliance information, consents and documentation required by the patient’s insurance plan(s). This includes a thorough understanding of accurately completing hospital-based compliance forms required by CMS. Uses multiple computer applications proficiently.

7. Consistently discusses financial liability with the patient(s) and/or families that includes: collection in full of patient liability, assisting patient in applying for Banner Line of Credit, setting up payment plans and/or assisting patient with Banner Financial Assistance policy/application.

8. Provides a variety of patient services and financial services tasks. May be assigned functions such as transporting patients, training new hire employees, recapping daily deposits, posting daily deposits, or conducting other work assignments of the Patient Access Services team.

9. Works independently under regular supervision and follows structured work routines. Works in a high-volume, fast paced, clinical environment which requires to ability to be adaptable, critical thinking, and independent decision making and to prioritize work and ensure appropriateness and timeliness of each patient’s care. Primary external customers include patients and their families, physician office staff and third-party payors.

MINIMUM QUALIFICATIONS

High school diploma/GED is required.

Must have customer service skills or knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience.

Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work both independently and collaboratively in a team environment. Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences. Strong knowledge in the use of common office software, word processing, spreadsheet, database software, and typing ability are required.

Employees working at Banner Behavioral Health Hospital, BTMC Behavioral, and BUMG, BUMCT, or BUMCS in a Behavioral Health clinical setting that serves children must possess an Arizona Fingerprint Clearance Card at the time of hire and maintain the card for the duration of their employment. An Arizona Criminal History Affidavit must be signed upon hire.

PREFERRED QUALIFICATIONS

Associate’s degreepreferred.

CRCR (Certified Revenue Cycle Representative) certification, a credential offered by the Healthcare Financial Management Association (HFMA)

CHAA (Certified Healthcare Access Associate) certification, a credential offered by the National Association of Healthcare Access Management (NAHAM)

Knowledge of medical terminology or healthcare systems.

Additional related education and/or experience preferred.

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