Patient Access Representative 2 - Hospital (Cancer Center)

Job Description

The Patient Access Representative 2 (PAR 2) facilitates a welcome and easy access to the facility and is responsible for establishing an encounter for any patient who meets the guidelines for hospital service. The PAR 2 ensures that all data entry is accurate, including demographic and financial information for each account. The PAR 2 has numerous procedural requirements, including data elements, insurance verification, and authorization for services; collections for all patient portions including prior balances; and balancing of cash at shift end. The PAR communicates directly with patients and families, physicians, nurses, insurance companies, and third-party payers. The PAR2 has the ability to, and serves as, team lead, lean Process improvement participant, new hire preceptor/mentor and/or auditor for regulatory and billing compliance.

Responsibilities

• Customer Service

• Effectively meets customer needs, builds productive customer relationships, and takes responsibility for customer satisfaction and loyalty.

• Represents the Patient Access department in a professional, courteous manner at ALL times.

• Asks patients if they may have special needs.

• Calls patients by name.

• Greets patients in a courteous and professional manner.

• Quality

• Adheres to the Passport accuracy percentage rate of 97.5 or above on a consistent basis when registering accounts.

• Supports the flexible needs of the department to accommodate patient volume in all areas of the hospital. This may require assignment to another area of the department, and shift change.

• Supports the department in achieving established performance targets.

• Completes training required as needed.

• Demonstrates reliability and dependability by reporting to work when scheduled.

• Financial Collections

• Calculates and collects the estimated patient portion, based on benefits and contract reimbursement as well as prior balances.

• Utilizes appropriate language and behavior to collect patient financial responsibility.

• Collects co-payments, deductibles, deposits and/or amounts due on previous accounts.

• Demonstrates knowledge and ability to review notes on all pre-admitted accounts and discuss with customer in a courteous and professional manner.

• Demonstrates knowledge and ability to review and explain previous accounts.

• Demonstrates knowledge and ability to complete account acknowledgement forms when appropriate.

• Collects cash, prints receipts, and balances cash drawers.

• Insurance and Benefits Knowledge

• Demonstrates knowledge of insurance plans.

• Verifies eligibility and obtains necessary authorizations for services rendered.

• Completes Medicare Secondary Payor Questionnaire.

• Utilizes online eligibility.

• Obtains authorization/verification of required insurance companies.

• Utilizes appropriate software and worksheets to calculate patient financial responsibility.

• Performs financial assessment for appropriate program assistance.

• Utilizes appropriate guidelines to assist patient with financial responsibility.

• Demonstrates accuracy in selected insurance plans (I-plans).

• Registration

• Obtains and accurately inputs all require data elements for registration, including patient demographic, financial information, guarantor information, and relevant notes associated with the encounter.

• Prioritizes and completes registration in a consistent, courteous, professional, accurate and timely manner.

• Ensures each patient is assigned only one medical record number.

• Selects appropriate patient type based on the department and services required.

• Communicates the purpose of and obtains patient/legal guardian signatures on all necessary hospital documents such as: hospital consent forms, assignment of benefits, patient rights, etc.

• Documents in account notes.

• Ensures orders are received and are consistent with tests/procedures.

• Gives patient documents that he/she needs to take with him/her to other departments.

• Leadership

• Serves in a team lead role (if assigned).

• Participates in/assists with performance improvement initiatives and demonstrates an understanding and compliance of all department policies and procedures.

• Mentors and trains other associates.

• Acts as auditor for regulatory and billing compliance.

• Other Duties as Assigned

• Performs all other duties as assigned.

Qualifications

Education: High School diploma or equivalent

Experience: 2 years relevant experience in the healthcare industry. Related certification (e.g. Certified Coder, Certified Medical Assistant) substitutes for 1 year of experience.