Patient Access Representative

Job Description:

Clerical Duties/ Telephone Switchboard 50%

1. Answers telephone, direct calls or takes accurate message, relaying messages to physicians and staff as needed.

2. Receives in-coming telephone calls and transfers such calls to the appropriate department, and pages people on the overhead paging system and text pager as needed.

3. Assist Revenue Cycle staff as needed

4. Complete requests for purchase order per instructions of Revenue Cycle staff, submit for signatures, forward completed purchase order to Central Supply.

5. Receives ordered items and restock storage area.

6. Greets visitors and routes them to various areas of the hospital.

7. Open, sort, date stamp and distribute all in-coming daily mail according to Revenue Cycle standards.

8. Receives and logs payments made through the mail before forwarding to the fiscal department.

9. Responsible for daily out-going mail by checking each for sufficient postage, certified or registered mail charges and preparing for pick-up by courier to the post office.

10. Maintains certified mail log.

11. Knows and follows processes/policies and procedures as necessary by switchboard operator during times of disasters and drills.

Admissions of Patients 50%

1. Interviews patient or their representatives and obtains demographic and insurance information.

2. Researches and update previous records within the information system or enters information to create a new file.

3. Initiates and completes all necessary admitting forms recognizing that these documents constitute a medical legal document.

4. Operates electric keyboard embosser and/or prints patient labels and wristband.

5. Explains hospital policies regarding room accommodations and visitors.

6. Ask all patients to present insurance cards and identifications.

7. Records billing information in the patient accounting system.

8. Verifies insurance benefits and eligibility for patients.

9. Assists patients with completing Medicaid applications, follow up and confirm applications were sent and received by MedQuest office.

10. Assures federal/state regulations, such as Medicare Secondary Payer Questionnaire (MSP), are understood and met through the registration/billing process. This includes, but is not limited to, the Emergency Medical Treatment and Active Labor Act (EMTALA).

11. Secures accounts by obtaining authorizations, pre-certifications, and referrals.

12. Informs patient or responsible party of deductibles, co-insurance, co-payments and other charges not covered by medical insurance plan.

13. Receives payments; issues receipts for all cash received; account for cash-on-hand (change fund); submit cash received, receipts and required control data to Accounting Office.

14. Ensures proper spelling of diagnosis or chief complaints is consistent with compliance and regulatory standards and hospital policies.

15. Provide Charity Care Application assistance as needed to patients who do not have medical insurance and/or to those that do not qualify for Medicaid.

16. Maintains compliance with HIPAA regulation, ensuring the patients' privacy requirements are met (e.g., P.C. screen is not visible to others, paper is protected at all times, open discussion in department does not reach the public).