Patient Access Representative

Job Summary:

To perform all registration responsibilities at Touchette Regional Hospital for patients seeking admission, emergency treatment, and/or outpatient services. This includes but is not limited to: order entry tasks, checking for Medical Necessity, and verifying insurance eligibility. This position also requires verifying charity eligibility, collecting insurance copayments, deductibles, and all other responsibilities associated with processing a patient visit.

Functions and Duties:

• Exhibits excellent customer service skills during any function of the registration process, including understanding when an interpreter is needed, providing patients with additional information regarding Medicare responsibilities, or more information regarding medical directives.
• Assist in the flow of data between physicians, physician office staff, nursing floors, ancillary departments, emergency department, patient business services, insurance companies and patients while insuring patient confidentiality is not breached.
• Assists patients with verification and pre-certification of insurances and acts a financial advocate for self-pay patients.
• Treat patients and coworkers with courtesy and discretion. Greets and directs patients, salespeople, and visitors.
• Registers patients by verifying that patient's record is up to date and accurate. Makes appropriate changes in computer system.
• Enters confidential personal health information and financial information into computerized system with a high rate of accuracy.
• Collects payment from patients, applies payments and adjustments to patient accounts in the computer system, and reconciles daily cash reports.
• Verify that all tests pass Medicare Medical Necessity. In the event a test fails, ensures that the Advanced Beneficiary Notice (ABN) is created and presented to the patient along with an information sheet describing to the patient their options.
• Ensure that the Medicare Secondary Payer Questionnaire is accurately completed with the responses provided by the patient and adjust Medicare payment sequence when necessary.
• Verify insurance eligibility for each patient using system program, and update the record to reflect any updated information or changes necessary.
• Document any and all discrepancies in the patient record that affects insurance.
• Confirm charity eligibility for all self-pay patients that meet hospital criteria and discuss the outcome with the patients.
• Performs all other duties as assigned.

Minimum Qualifications:

Education

• High school diploma or GED equivalent required.

Experience

• Minimum of 6 months in an office/clerical role preferred.
• Patient access experience in a healthcare setting is preferred.

Certifications, Licenses, and Registrations

• Certified Healthcare Access Associate (CHAA) is preferred.

Skills and Abilities

• The ability to type a minimum of 40 wpm.
• Knowledge of health insurance and medical terminology required.
• Must have excellent interpersonal communication skills, and the ability to work with patients, their family and the general public.

Physical Demands:

• Must be able to sit and/or stand for prolonged periods of time.
• Must be able to wear personal protective equipment (PPE) (mask, gown, gloves) when required.
• Must be able to use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell.
• Must occasionally lift and/or move up to 25 pounds. May be required with assistance to push someone in a wheelchair.
• Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.