Representative - Longstreet Clinic - Patient Access Service Center

** Job Category:
** Clinical Support
** Work Shift/

Schedule:

** 8 Hr Morning - Afternoon
** Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.**##
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* About the Role:

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** Job Summary
** Under the supervision of the Patient Access Service Center Supervisor/Manager, this position is responsible for ensuring the delivery of outstanding customer service while scheduling, obtaining complete and accurate patient demographic information, identifying patient benefits and eligibility, obtaining pre-certification approvals from insurance companies and Physicians offices, identifying insurance and/or patient responsibility, collecting identified co-pay/deductible and/or providing financial counseling when appropriate, and completing the pre-registration process.#

** Minimum Job Qualifications**
* ** Licensure or other certifications:**
* *
* Educational Requirements:

** High School Diploma or GED
* *
* Minimum Experience:

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* ** Other:**#
** Preferred Job Qualifications**
* ** Preferred Licensure or other certifications:**
* ** Preferred

Educational Requirements:

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* *
* Preferred Experience:

** Two(2) years previous hospital registration/business office experience
* ** Other:**#
** Job Specific and Unique Knowledge,

Skills and Abilities

*** Ability to work independently, emotionally mature, and able to function effectively under stress
* Good communication skills
* Excellent problem solving and analytical skills
* Excellent written and oral communication skills
* Ability to prioritize, organize, and coordinate daily work load
* Working knowledge of Protected Health Information
* Ability to manage change
* Must possess detailed understanding and knowledge of insurance guideline and protocols, the components of full verification, and payor information / requirements#
** Essential Tasks and Responsibilities
*** Responsible for data entry into scheduling system (for OR, Cardiology, and Radiology areas as assigned) including all information obtained from patient, Physician, and/or surgery staff. This data is including, but not limited to, correct procedures, diagnosis codes, and patient insurance information.
* Responsible for identifying available times for scheduled procedures; ensures prompt scheduling to meet the convenience of patients, however, allows adequate time to complete insurance verification and authorization process as efficiently as possible without compromising the procedure.
* Performs medical necessity checks on all appointments in which it is applicable; completes ABN notification upon any failure to meet medical necessity.
* Obtains complete and accurate insurance information and completes insurance verification by contacting patients, Physician offices and insurance/payer regarding the visit; verifies patient’s insurance eligibility and benefits with the information obtained.
* Works according to standard operating procedure during ADT/system downtimes.
* Identify patient's history in all Patient Access Systems to avoid duplication of medical records.
* Responsible for capturing and documenting all pertinent patient demographic, subscriber, and insurance information i.e.; patient policy and , subscriber, guarantor, payor address, phone number, and contact information. Documentation must include, effective date, copay, deductible, out of pocket, co-insurance, percentage of coverage and any other pertinent information concerning the specific hospital visit into the ADT system.
* Reviews work and assures accuracy in all aspects of the position; particularly, procedure scheduled, patient type, pavilion code, insurance information, and demographic information to minimize error rate and time delays in other areas.
* As assigned, responsible for assuring all scheduled and non-scheduled inpatient and outpatient accounts are authorized either in advance or on the day of the service/admission date and within the time frames and guidelines set forth by the organization and payer; pre-certification is expected to be documented timely and appropriately.
* Responsible for assessing financial responsibility for scheduled patients; communicates financial liabilities to patients prior…