Patient Access Associate Ii

Overview

The Patient Access Associate II for the Electrographic Service Line at Riverside Healthcare is responsible for registering, scheduling, and verifying insurance/Medicare/Medicaid compliance while delivering exceptional customer service. This role requires strong organizational skills, the ability to work independently in a fast‑paced environment, and a compassionate approach to patient interaction. The Patient Access Associate II plays a critical role in ensuring a smooth revenue cycle process by accurately collecting and analyzing patient demographic, insurance, and clinical data, securing payment authorization, and resolving discrepancies in collaboration with various departments.

Demonstrates flexibility with assignments within professional scope/duties/licensure.

Essential Duties

Patient Registration & Scheduling:

• Efficiently register and schedule patients, ensuring accurate collection of demographic, insurance, and clinical data across all payer classes.
• Preregister appointments during scheduling whenever possible to facilitate smooth patient processing and timely insurance verification.
• Provide patients with clear instructions for tests, procedures, and treatment locations, optimizing their schedules for convenience and continuity of care.

Insurance & Compliance Verification:

• Screen for compliance with payer requirements, including medical necessity, precertification, and third‑party eligibility.
• Complete benefit verification for all insurance types, including Medicare and Medicaid, ensuring the accuracy of information to secure payments.
• Adhere to EMTALA, HIPAA, payer, and other applicable regulations during the registration process.

Customer Service & Communication:

• Greet patients and their representatives with courtesy and compassion, identifying yourself and guiding them through the registration process.
• Maintain effective communication with patients and families, ensuring they understand all steps and addressing any delays.
• Listen and respond to patient inquiries, providing appropriate guidance or redirecting calls as necessary.

Data Accuracy & Documentation:

• Accurately collect, analyze, and electronically record all necessary demographic, financial, and clinical data for billing and compliance purposes.
• Review previously recorded patient information to identify discrepancies and resolve them by reverifying payer details and medical necessity.
• Provide thorough and timely documentation of all patient interactions, ensuring records are accurate and up to date.

Work Flow Management & Prioritization:

• Assess work flow priorities to respond to incoming calls and outstanding orders in a timely manner.
• Monitor call volumes using appropriate software, adjusting staffing levels to meet departmental needs.
• Attend all mandatory education sessions and departmental meetings to stay informed about best practices and procedural updates.

Non‑essential Duties

• Stay updated on regulatory compliance changes, including payer regulations and HIPAA Privacy and Security requirements.
• Assist with special projects as assigned by supervisors.
• Maintain and organize personal reference materials to ensure quick access to financial and clinical information.
• Participate in quality improvement initiatives as needed.

Preferred Experience

• Minimum of 1‑2 years of office or clerical experience, preferably in a healthcare setting.
• Strong computer literacy and familiarity with healthcare software systems.
• Prior experience in a call‑center environment is preferred.
• Knowledge of healthcare payer regulatory compliance and the hospital revenue cycle.
• Ability to perform general arithmetic and interpret data with attention to detail and accuracy.
• Excellent verbal communication skills with the ability to interact in a respectful and compassionate manner with patients, families, and colleagues.

Required Licensure/Education

• High School Diploma or equivalent required.

Preferred Education

• Completion of medical terminology coursework preferred.

Employee Health Requirements

Exposure to:

• Chemicals:
  None
• Video Display Terminals:
  Average
• Blood and Body Fluids:
  Performing ER and Admitting registrations have the potential to be exposed.
• TB or Airborne…