Pre-Access Representative

Pre-Access Representative

The Pre-Access Representative will be responsible for handling the flow of scheduling calls. The essential responsibilities include pre-registration, scheduling, obtaining accurate demographics, providing exam preparations, and collection of appropriate authorizations/ICD codes in a courteous and efficient manner. They will be responsible for completing accounts with eligible insurance and authorization and complete patient pre-registration for scheduled procedures. The Representative will verify the patient payer eligibility, benefits/coverage, and estimated payment responsibility, confirm authorization requirements and secure on the account.

The Representative will complete pre-registration phone interviews, to include obtaining necessary pre-registration information, including demographics, insurance information, and Medicare MSPQ, with documentation completed in the electronic medical record account. During the pre-registration interview, the representative will notify patient of potential financial responsibility and collect payment via phone, review issued Medicare ABN (Advance Beneficiary Notification), provide direction to facility and registration desk, and educate the patient regarding what items are required as part of the patient's facility registration process.

STATUS: FULL-TIME

LOCATION:

SLH MARKET 201 Market Street
- Potsdam, NY 13676

DEPARTMENT: COMMUNICATION CENTER

SCHEDULE:

MONDAY - FRIDAY 8AM-5PM

RESPONSIBILITIES:

Scheduling Procedures:

• Answers phones from patients/customers professionally and responding to patient/ customer complaints.
• Performs correct name inquiry and identifies patient according to policy and procedure without errors
• Schedules patients/customers based on scheduling guidelines and medical appropriateness.
• Receives a high volume of inbound calls with varying degrees of questions and concerns.
• Obtaining and collecting all necessary information from the patient/ customer to schedule and register the patient for an appointment.
• Consults with referring physician's office to ensure written and/ or electronic orders exist and obtain them as needed.
• Collects patient financial data, insurance, authorizations, and reference numbers.
• Collects complete demographic information of patient including address, phone number.
• Collects medical information to include patient complaint

Revenue Cycle:

• Views insurance card(s) and scans into computer system reviewing for mandatory precertification and/or other third party payer requirements
• Obtains Inpatient/ Observation patients precertification's
• Re works accounts to ensure accurate patient statuses
• Collects complete financial information to include payer name, identification number, group number, subscriber name, guarantor name and address, and precertification numbers
• Selects appropriate financial class and insurance code
• Performs online real-time eligibility verification and registration scrub via AHIqa and makes changes to registration errors accordingly and in a timely fashion
• Screens for insurance edibility via insurance websites, where appropriate
• Completes Medicare Secondary Payer Questionnaire for all Medicare-eligible patients
• Completes all admission forms required by Medicare
• Verifies third party payer benefits and Worker's Compensation according to departmental policy and procedure
• Collects any patient-pay balances such as copay, co-insurance, or deductible at time of registration
• Refers patient to Patient Financial Advocacy Program when appropriate and per departmental procedure
• Balances cash draw, completes cash receipt, issues patient receipts and secures safe daily with no exceptions

Registration/Pre-Registration:

• Interviews the patient and/or family member either in person or by telephone to collect demographic, financial, and medical information
• Performs correct name inquiry and identifies patient according to policy and procedure without errors
• Collects complete demographic information of patient including address, phone number, and employer
• Collects medical information to include patient complaint
• Explains consent information, obtains signatures, witnesses (legibly) with no omissions
• Obtains copy of patient identification document(s)
• Completes registration process within five minutes for preregistered patients and ten minutes for non-preregistered
• Contacts physician offices to obtain and confirm patient information
• Customer Service
• Practices proficient customer service skills by greeting and treating all patients and staff with respect and discretion
• Capable of empathizing with the circumstances of patients and families while maintaining and objective approach to the disposition of each account
• Provides and explanation of any patient wait and responds to all patient requests. Notified manager of any patient wait times longer than 15 minutes.
• Greets each patient and identifies self by name and role
• Notifies the manager of incidents, errors or patient complaints
• Maintains patient privacy and confidentiality at all times according to established…