Patient Access Representative - Urgent Care Ryland

Position Purpose

This position is responsible for performing all registration, scheduling, order entry, and reception functions and may float to various admitting sites within the health system.

The role expedites and provides healthcare access through the accurate gathering of demographic, sponsorship or guardian data, insurance, clinical, financial, and statistical information from patients, families, physicians, physician office staff, county and/or governmental agencies, CMS, FMS, etc.

Ensures reimbursement for services rendered through verification of insurance eligibility/benefits, obtaining insurance authorization within required time frame, identifying and collecting patient financial obligations, and accurate charge order entry. Serves the patient and family to make the admission process as comfortable and pleasant as possible.

The incumbent uses professionalism and diplomacy while interacting with patients of all ages, their families, physicians, physician office staff, and other health care providers in accurately collecting demographic, clinical, and financial information in person or via telephone interviews.

Takes an active role in decreasing accounts receivables by following established guidelines, regulations, policies, and procedures during the registration process in accurately:

• Obtaining and accurately entering demographic, clinical, financial information into the computer system.
• Explaining and obtaining signatures on admission, clinical, and financial forms.
• Collecting accident information.
• Identifying all insurance payer sources.
• Identifying payer order sequence.
• Verifying insurance eligibility.
• Obtaining insurance notification.
• Charge order entry processing.
• Determining estimated cost for services being rendered.
• Identifying and collecting patient financial obligations, i.e., co-payments, co-insurance, deductibles, etc.
• Documenting all information collected timely and in accordance with department requirements.

Explores the financial need of the patient and, when appropriate, refers the customer to the appropriate federal, state, or county assistance agencies.

The incumbent is responsible for scheduling, order entry, and reception functions and assists in completion of departmental tasks.

This position has the authority to solve problems following established company guidelines. Decisions that must be referred to a supervisor involve issues such as problems that could negatively affect the company, time off requests, sick time, work schedules, interoffice problems, etc.

Additional responsibilities include:

This position does not provide patient care.

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Education: Must have working-level knowledge of the English language, including reading, writing and speaking English. High School Diploma or GED preferred.

Experience: Requires six months of admitting, medical claims processing, professional office experience and/or customer service experience with financial interaction. One year preferred. Experience with Windows Operating systems, SMS InVision, Internet and SMS IMS Document Imaging is also preferred.

License(s): None

Certification(s): None

Computer / Typing: Must possess, or be able to obtain within 90 days, the computer skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.