Patient Access Representative; M-F

Position Summary

Responsible for the registration of all patients accessing services at Cleveland Area Hospital with emphasis on patient access/satisfaction, insurance/demographic verification, obtaining authorizations/precertification for services and point of service collections, while maintaining accuracy, confidentiality, professionalism, and patient privacy continuously.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

• Adhere to all policies of the organization, including job description, certification/licensure requirements, mission statement, HIPAA, confidentiality standard and patient’s rights.
• Make a positive contribution to the organization’s culture and stay up to date with organization’s communications and directives.
• Greets all patients and guests and assists with access to services and ancillary departments within the hospital.
• Properly identifies patients to register encounter in EMR system to ensure timely and accurate reporting/billing.
• Demonstrates streamlined processes to maintain safety and quality through accurate patient identification, validates/updates Master Patient Index (MPI) according to departmental policy, protects personal health information, and accurately interprets physician orders, as evidenced by quality audits and reviews.
• Responsible for distribution of patient related materials to ancillary departments.
• Obtain patient or designee’s signature on all necessary documents.
• Obtain and verifies insurance eligibility through various systems.
• Identify and collect copay, deductible, coinsurance, or any monies owed for services.
• Check in visitor and vendors to ensure patient safety standard guidelines are met.
• Complete required Medicare forms and questionnaires with patients or legal designee.
• Adheres to HIPAA and EMTALA guidelines.
• Verifies required information on physician’s orders.
• Obtains ICD
  10 and CPT codes to verify Medical Necessity to ensure reimbursement from CMS.
• Functions as primary Switchboard Operator while maintaining registration standards.
• Acquires authorization/precertification for applicable services.
• Coordinates with daily schedules and schedulers to maximize registration time for pre‑registered services.
• Audit accounts for errors before each shift ends.
• Complies with infection control guidelines by practicing proper hand washing, cleaning of Patient Access areas, and documenting in SQSS.
• May be responsible for daily deposit preparation.
• Supply order and stocking.
• Attend required department meetings.
• Attend required educational, compliance and safety program sessions.
• Complete required educational SWANK assignments.
• Assist with training when required.
• Adheres to department dress code policy.
• Assists patients entering and exiting the facility.
• Maintains a clean, well‑organized work area.
• Other duties as assigned.

High School diploma required. Must possess excellent communication and organizational skills. Working knowledge of computer-based applications and strong PC/keyboard skills are a must. Detail oriented, able to organize paperwork and flow of patient through the registration process while maintaining a professional image. Must be customer service driven.

Experience:

1‑2 years of experience in medical field, hospital, or physician office.

This position could have access to patient confidential records and must comply with HIPAA regulations as well as Compliance Policies.

Equipment:
Computer, Printer, Copy Machine, Fax Machine, Telephone.

Working Conditions:

The physical demands described here include being required to talk or hear, sit for extended periods of time; stand; walk; use hands to finger, handle or feel; and reach with hands and arms. Must be able to push, pull 250 lbs. and lift 50 lbs. using appropriate body mechanics techniques. Occasionally requires bending and stretching. May be exposed to communicable diseases.

The position requires 24/7 availability, which may necessitate work beyond normal scheduled shifts, including holidays and inclement weather, and compliance with Cleveland Area Hospital’s attendance policy.