Patient Access Representative PRN Job at United Surgical Partners International Inc (USPI) (Oklahoma City)

Job Description

The Patient Access Representative is responsible for the complete and accurate registration of all patients obtaining services at the facility. Responsible for accurately gathering and entering patient information into the computer as received from the patient and/or the physician’s office, verifying benefits for non pre-registered patients, and obtaining signatures on required forms. Responsible for collecting co-payments, deductibles, and co-insurance from patients at the time of service. Responsible for ensuring an efficient, complete, and timely patient registration process that models the customer service philosophy of the facility.

Job Responsibility

Communicate with clinical departments or Scheduling Representative to obtain scheduled appointments and/or orders prior to the service date
Pre-register 98% of all scheduled patients a minimum of three (3) business days in advance of their arrival
Obtain, validate and accurately enter in the computer system, the patient’s demographic and insurance information while maintaining an acceptable accuracy rate (95% plus) as evidenced by routine quality review
Thoroughly review the MPI so that duplicate medical records numbers are avoided
Obtain signatures on all necessary forms and documents required by hospital and by law
Ensure MSP Questionnaire is completed for every Medicare registration
Work closely and cooperatively with the physician office staff, schedulers and other hospital departments to schedule and prepare required information before the patient’s arrival
Utilize online programs to verify insurance eligibility and benefits, documenting findings on the patient account
Assist by contacting to the insurance company for pre-authorizations and pre-certifications as required prior to patient receiving service when asked by Director
Effectively communicate with physician office staff to resolve authorization issues and coordinate registrations as required
Collect co-payment, deductible or co-insurance previously identified by the Insurance Verification Specialist or as indicated on the insurance card or online eligibility system, when the patient arrives for service
If working in Emergency registration, ensures compliance with the EMTALA regulation for all patients
Log cash collected, generate receipts, and maintain balanced cash at all times
Meet monthly cash collection goals as determined collaboratively by Department Director/Manager and CBO
Consistently obtain and copy/scan insurance cards and driver licenses
Responsible for knowing the functions of the phone system in order to professionally handle incoming calls, appropriately transfer calls, and assist with any internal calls when asked to do so by Department Director or Team Lead
Perform the reception/greeter function at the front desk entrance as needed
Verify medical licensure and check Medicare Sanctions websites for non-credentialed physicians ordering outpatient diagnostic tests (Community Hospital Only)
Consistently demonstrate premier customer service and communication skills with all internal and external customers/contacts and ensure the patient and their family members have the best hospital encounter possible
Meet established quality and productivity standards for self and for the team
Anticipate and adapt to change (e.g., hospital policy changes, operational/procedures, insurance changes) in a positive manner
Foster and reinforce team-based results
Adhere to time and attendance standards as outlined in the Human Resource Policy manual
Provide proper notification of absence or tardiness within established departmental time frames
Ensure patient confidentiality adhering to HIPAA guidelines
Demonstrate the knowledge, skills and abilities (competencies) to perform the duties outlined above annually in the form of a test or as evidenced by daily quality review and direct observation of the Team Lead and the Department Director/Manager
Track and monitor productivity as requested
Keep Department Director or Team Lead apprised of any delays in the registration process
Remain current on scheduling, registration, insurance verification, and other patient registration processes in order to cover in the absence of other team members
Perform other duties as assigned

Requirements

High School graduate or equivalent required
2 years college preferred
Experience in patient registration, verification and authorization in a medical center or comparable institution demonstrating the skill, knowledge and ability to perform registration duties preferred
Working knowledge of governmental regulations and other reimbursement criteria preferred
Ability to accurately type 40 WPM, complete forms, simple correspondence, handle payment transactions and enter data
Excellent verbal and written communication as well as interpersonal skills required
Demonstrated ability to handle multiple tasks with short time-lines, prioritize and organize work, and complete assignments in a timely and accurate manner
Exceptional ability to interact and communicate effectively, tactfully, and diplomatically with patients, families, medical staff, co-workers, employers and insurance company representatives
Must have a pleasant disposition, positive attitude and possess the ability to maintain a cordial and professional approach during periods of stress
Skill in using office equipment: basic computer skills, photocopier, telephone, fax machine, and calculator
Demonstrated ability to think and act decisively in a timely manner
Ability to maintain operational knowledge of all insurance requirements necessary to achieve optimal reimbursement

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Patient Access Representative PRN

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