Patient Access Services Representative

• Assists medical care givers with patient management, tracking and monitoring requirements
• Answers phones, pre-screens using appropriate triage skills, within allowable parameters calls in prescription re-fills, calls patients with test results and schedules patients for next appointments
• Perform extensive centralized scheduling, insurance verification, referral, billing and payment posting responsibilities
• Exhibits excellence in customer service
• Collects deposits or deductibles and advises patient or guarantor of insurance benefits and anticipated cost estimates
• Ensures completion of financial documentation
• Explains all necessary compliance forms and obtains patient signature
• Performs medical necessity screening
• Interacts with physicians and/or physicians’ office staff to secure diagnosis, procedure details or authorizations
• Uses medical terminology and scheduling knowledge to select correct procedure
• Demonstrates knowledge of resources, staffing, instrumentation, and equipment specific to procedures
• Performs patient registration activities
• Completes insurance processing
• Communicates with departments/physicians for special requests
• Handles incoming telephone calls and exercises judgment in scheduling
• Explains procedure preparations to patients
• Documents all notification, authorization and eligibility information
• Analyzes patient accounts, determines non-collectable accounts, and recommends bad debt or charity write-offs
• Arranges payment methods or extensions of credit with patients
• Arranges account collections and contacts carriers to follow-up on balances due
• Maintains current working knowledge of payer regulations
• Provides information about external financial assistance
• May serve as a Medical Assistant when holds a Medical Assistant Certification
• Processes Accounts Payable transactions
• Adheres to TMCH organizational and department-specific safety, confidentiality, values policies and standards
• Performs related duties as assigned

• High School diploma or General Education Degree (GED)
• Preferred one (1) year of medical office and/or hospital experience to include healthcare eligibility and benefit analysis or scheduling experience for diagnostic testing and/or surgery
• Some positions may require certification as a Medical Assistant (CMA)
• Knowledge of office management practices, including billing and scheduling within healthcare
• Knowledge of basic computer familiarity and experience and the ability to operate basic office equipment
• Knowledge of patient care protocols and practices
• Knowledge of general patient care practice, methods and regulations
• Skill in evaluating patient’s needs or following up with a care-giver and then providing follow up support to patients
• Skill in scheduling appointments and referrals
• Ability to read or listen and comprehend simple instructions, short correspondence, and memos
• Ability to write simple correspondence
• ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization
• Ability to read and interpret documents such as safety rules, procedure manuals, and governmental regulations
• Ability to effectively present information and respond to inquiries or complaints from patients and/or their representatives and the general public
• Ability to interpret and explain insurance benefits and patient financial responsibility
• Ability to provide excellent customer service via phone and walk-ins
• Ability to apply common sense understanding to carry out simple/detailed written or oral instructions
• Applicants must have basic computer familiarity and experience and the ability to operate basic office equipment

Completion of vocational medical office training