Patient Access Representatives provide customer-service coverage in the centralized front office of Jennie Stuart Medical Center, and assume the responsibility for successful financial outcomes of all patient services. Under the general supervision of the Patient Access Manager, this position performs imperative duties, including but not limited to, registration in outpatient and emergency department, insurance verification, telephone coverage, data entry, and point-of-service collections, while maintaining patient relations, customer satisfaction, and Jennie Stuart Medical Center’s financial solvency.
Organizational Expectations
• Provides a positive and professional representation of the organization.
• Promotes culture of safety for patients and employees through proper identification, reporting, documentation, and prevention.
• Maintains hospital standards for a clean and quiet patient environment to maintain a positive patient care experience.
• Maintains competency and knowledge of current standards of practice, trends, and developments in related scope of job role or practice.
• Adheres to infection-control policies and protocols, medication administration and storage procedures, and controlled substance regulations.
• Participates in ongoing quality improvement activities.
• Maintains compliance with organization’s policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards.
• Complies with organizational and regulatory policies for handling confidential patient information.
• Demonstrates excellent customer service through his/her attitude and actions, consistent with the standards contained in the Vision, Mission, and Values of the organization.
• Adheres to professional standards, hospital policies and procedures, federal, state, and local requirements, and TJC standards and/or standards from other accrediting bodies.
• As a Studer Partner must have the ability to develop a full understanding of the Studer Group practices and tools and communicate effectively. Must embrace the Studer Philosophy and Principals by conducting him/herself in a professional manner. Will be held accountable to the following Studer Philosophies and Principles:
Essential Functions
• Responsible for timely and accurate registering of patients. Registers patients for admissions, emergency and outpatient services according to departmental policies and procedures in an accurate and timely manner.
• Interviews patient for all demographic information form patients assuring complete and accurate data by maintaining at least a 98% accuracy rate tracked by departmental performance improvement plan.
• Verifies insurance coverage.
• Offers assistance and provides direction to patients, visitors, physicians and families in an informative, positive and courteous manner.
• Understands insurance deductibles, co-pay, and coinsurance in order to explain and educate the patient.
•Request/collects patient's payments and issues receipts.
• Understands financial payment options available to patients.
• Opens individual upfront collection log and assures it is in balance at end of shift.
• Makes appropriate documentation in system.
• Pre-registers scheduled patients.
• Completes all shift activities and communicates current situations to the next shift for continuity of the department.
• Answers incoming phone calls to Patient Access.
• Demonstrates knowledge of Accountability, human growth and development and the care of patients appropriate to the ages of patient served.
• Adheres to HIPPA privacy regulations in accordance with hospital's policies and procedures.
• Employee demonstrates an understanding of and adherence to the Jennie Stuart Medical Center Mission, Vision and Values.
• Other duties occasional assigned performed timely and accurately.
Required Skills
Minimum Education
• Must be a high school graduate or equivalent required.
• Associate's or Bachelor's degree in healthcare administration, business administration, or related field desired.
Basic knowledge of the following:
• Mckesson and AccuReg
• Medical terminology
• ICD-10, CPT, HCPCS codes and coding processes
• Hospital and professional billing processes and reimbursement
• Various payer regulations and contracts
• Superb customer service, teamwork, and conflict resolution skills
• Efficient time management skills and ability to multi-task
• Excellent writing, oral, and interpersonal communication skills
• Exceptional organizational, planning, coordinating and collaborating skills
• Strong understanding and comfort level with computer systems
Required Experience
Minimum Work Experience
• At least 1-3 years of customer service, administrative, and/or data entry experience required.
• At least 1-2 years of experience in a healthcare environment preferred.
• Experience with database software applications desired.
Minimum Education
• Must be a high school graduate or equivalent required.
• Associate's or Bachelor's degree in healthcare administration, business administration, or related field desired.
Basic knowledge of the following:
• Mckesson and AccuReg
• Medical terminology
• ICD-10, CPT, HCPCS codes and coding processes
• Hospital and professional billing processes and reimbursement
• Various payer regulations and contracts
• Superb customer service, teamwork, and conflict resolution skills
• Efficient time management skills and ability to multi-task
• Excellent writing, oral, and interpersonal communication skills
• Exceptional organizational, planning, coordinating and collaborating skills
• Strong understanding and comfort level with computer systems