Patient Access Rep PT Urgent Care-Fulton

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Job Title:
Tier 1 Patient Access Representative Department:
Patient Access

Reports to:
Patient Access Manager Revision Date: 7/31/2020

Job Summary:

The Patient Access Representative communicates with physician offices, staff, multiple service areas, and patients to obtain demographic and insurance information for preregistration and registration on all patients for prompt and accurate patient billing. Ensures compliance of admission and discharge practices established by regulating agencies and third-party payers. Communicates Oswego Health’s financial policies and required documents to patients and identifies patients that require financial counseling.

Collects on self-pay accounts, co-payments and deductibles. Identifies outpatient authorization requirements and medical necessity at time of patient visits. Other responsibilities include verifying benefits and order entry.

• Communicate with physician’s office staff, other members of health care team, and co-workers to ensure the flow of accurate and timely information, maintain collaborative relationships, and promote excellent customer service and quality patient care.
• Perform third party verification and payer eligibility requirements with knowledge of payer requirements, including No Fault and Workers Compensation Claims
• Initiate service authorizations for services requested from practitioners. Record pertinent data for B/AR and Case Management use.
• Complete forms using medical terminology, seeking assistance or using resources when necessary, to ensure accurate documentation of patient visit complaints and admission diagnosis descriptions.
• Follow physician entry procedures, including but not limited to, Doctor Other, multiple locations, and address changes.
• Interview patient and/or guarantor to obtain and process accurate and complete patient information. Obtain appropriate signatures on required forms.
• Scan required patient information, insurance and state , Advanced Directives, and other registration forms; receive notices of service requisitions from providers; record pertinent data for claims submission.
• Provide patients with all required notices, including but not limited to HIPAA, Health Care Proxy, and Patient Bill of Rights.
• Complete daily, weekly, monthly tasks in a timely manner, inclusive of but not limited to financial support activities and designated department and organization competencies.
• Complete and process forms, including but not limited to, Medicare questionnaire and service authorizations.
• Perform outpatient, scheduled, and pre-registered patient registrations;
  Discharge patients when needed.
• Work on multiple electronic systems to identify online orders or other patient appointments.
• Collect cash, credit card or other forms of payments; perform discounts as appropriate. Open and close cashiering windows and balance payments.
• Export images as needed to CD’s; film/image sign out and release.
• Adhere to Accounting of Disclosures for patient record requests.
• Complete all competencies for the scheduled or covered area, including Surgical Center, Emergency Department, Lab and Radiology Registration, Urgent Care.
• Process incoming and outgoing mail per policy and instruction.
• Respond to administrative calls and/or complaints
• Operate Switchboard by taking incoming calls and transferring calls, maintaining positive tone.
• Respond to third party visitors.
• Perform order entry of radiologic tests.
• Follow code entry and ABN requirements per CMS guidelines
• Review orders/requisitions and diagnosis to ensure compliance and legality of order. Perform quality measures including correct diagnosis code, correct scheduled study, authorization requirements, provider entry, and other forms of quality procedures.
• Perform electronic ordering registration procedures, including courier procedures.
• Correctly identify patient scheduled appointments, visits and other patient types.
• Perform downtime procedures according to policy and procedure.
• Ensure accurate registration and compliance using all resources and education provided.
• Maintain knowledge of emergency codes and safety measures.
• Maintain knowledge of direct and transferred admissions as well as outpatient registration procedures.
• Ensures all work areas are adequately stocked with supplies to provide quality services.
• Perform other duties as assigned.

Required Skills/Abilities (Unit Specific):

• Skilled in PC/CRT data entry; proficient in…