Patient Access Representative
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.
PRINCIPAL JOB DUTIES AND RESPONSIBILITIES:
Adhere to all policies of the organization, including (but not limited to) 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 ICD10 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.
Note: The Patient Access Department provides patient care 24/7. In order to provide the highest quality care to our patients, individuals may be required to work beyond normal scheduled shifts and will be required to comply with Cleveland Area Hospital’s attendance policy. This includes holidays and inclement weather. Employees are expected to arrive at their position, in uniform, and using the hospital time system, be clocked in promptly at the beginning of their shift.
Computer and Printer
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.
1-2 years of experience in medical field, hospital, or physician office.
RESPONSIBILITY FOR CONFIDENTIAL INFORMATION:
This position could have access to patient confidential records and must comply with HIPAA regulations as well as Compliance Policies.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to 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. Utilizes good hearing, vocal and visual skills. Occasionally requires bending and stretching. Pushing and pulling. May be exposed to communicable diseases.