Patient Access Representative - Nelson Clinic - Ophthalmology

Position: Patient Access Representative - Nelson Clinic - Ophthalmology - Days
Verifies insurance coverage and understands requirements for HMO, managed care, government and private plans. Secures required referrals/authorizations and links them correctly in the referral module. Obtains needed referrals and authorizations before scheduled procedures, tests, injections and surgeries. Communicates plan-specific referral/authorization requirements to patients and providers.  Provides pre-payment guidance for self-pay patients and offers financial assistance. Prepares cost estimates, explains payment expectations and documents all interactions in the patient account.
Maintains proficiency in all aspects of patient medical record keeping in an organized manner. Assists in preparation of the chart before the patient visits. If applicable, assists in breaking down the chart at the completion of the patient's visit. Ensures that all patients arrived in the appointment scheduling system before the end of the appointment day. Where appropriate, appointments are documented as “no-shows” or cancellations before the end of the appointment day.

Obtains signatures and completes the required forms including those from managed care and other insurance plans.
** Miscellaneous Responsibilities
** Performs other duties as assigned and/or participates in special projects to support the mission of VCUHS and department.
** Employment Qualifications
*
* Education Required:

High School Diploma or equivalent

Education Preferred:
Associates or Bachelor’s Degree in Accounting, Finance, Business Administration, Healthcare Administration or closely related field from an accredited program.
** Minimum Qualifications
** Years and Type of

Required Experience:

Demonstrated experience using computers, Microsoft Office applications, and web-based platforms  

Experience Preferred: Work experience with medical insurance, HMO, managed care, electronic medical billing/order entry/registration systems, and appointment scheduling.

Previous work experience in a healthcare setting, and  knowledge of medical terminology.

Other Knowledge, Skills and Abilities Required:

Able to perform daily activities with minimal supervision: being self-directed in the accomplishment of routine activities.

Other Knowledge, Skills and Abilities Preferred:

Depending on assignment, may be required to work off-shifts and/or weekend and holidays.  
** Physical Requirements
**** Additional

Physical Requirements / Hazards
*
* Physical Requirements:

Manual dexterity (eye/hand coordination), Perform shift work, Hear alarms/telephone/tape recorder, Repetitive arm/hand movements
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