Patient Acess Rep
Kansas City Metro, (none selected)
This position conducts professional patient interviews obtaining demographic, financial, and biographical information. The Patient Access Representative is responsible for understanding insurance terminology, obtaining information to appropriately bill payors, verify patient insurance eligibility, confirm benefits eligibility, and gather statistical information in compliance with federal and state regulations. Complete payment transactions by using proper negotiating techniques to professionally collect money owed by our Patients and Guarantors, including making referrals to appropriate financial resources such as payment plans and lines of credit. The Patient Access Representative is responsible for the delivery of quality performance and service excellence. Strong computer skills, critical thinking skills and the ability to multitask in a fast paced work environment are required.
Collaborates with other staff to facilitate patient admission. Maintains productivity and attendance patterns that support the team. Responds to requests for information within specified deadline. Prepares and distributes reports to user department. Relays information to relief shift to ensure follow-through of relevant needs of departments patients and physicians. Assists in training of new employees by sharing information and experience. Builds a strong relationship with members of other departments.
Accurately and completely enters all patient demographic data in computer. Seeks out missing or incomplete information by following up with patient family and other appropriate sources . Accurately completes all required fields in the computer to ensure claims pass edits. Understands Patient Accounting bill and claim edit requirements. Accurately determines appropriate insurance codes to ensure accurate billing of claims and reduce Out of Network denials to maximize reimbursement and to ensure accurate decision support information. Collaborates with various hospital personnel to obtain appropriate bed assignment diagnosis and other visit specific data to ensure accurate medical record information. Utilizes incident reporting system to report non-compliant actions or activities to promote a safe and secure environment.
Greets patients and visitors in a pleasant, professional, and polished presence in a helpful and courteous manner to provide positive first image. Confidentially and respectfully interviews patient to obtain necessary demographic information. Informs patients of their patient rights, payment policy, Medicare letter, Health Exchange opportunities, My Chart and other regulatory required information. Utilizes critical thinking skill to minimize patient wait time and meet clinical department needs by prioritizing patients and keeping patient informed. Evaluates and responds to patient needs through compassion, empathy and sensitivity. Responds to all inquiries by relaying complete and accurate information. Answers all calls in courteous and helpful manner.
Learning and Innovation
Stays informed of changes in policy, procedures and regulations that impact daily workflow. Attends classes as needed to continuously improve skills. Takes initiative and action to handle unique situations and requests. Demonstrates understanding of Admitting role in the revenue cycle. Participates in Quarterly Education. Identifies process concerns and offers suggestions on process improvements. Working knowledge of software applications as related to job activities.
Accurately selects accommodation code and level of care to ensure appropriate room charge. Changes patient types to reflect status changes throughout the patient stay to ensure accurate charges and reimbursement. Demonstrates knowledge of EMTALA guidelines to prevent violation. Reviews account information to ensure authorization is obtained, eliminate incorrect insurance plans being loaded, discuss and educate the patient regarding their financial obligation and make the referral to appropriate resources to assist in paying their bill. Complete all payment transactions completely and accurately.