Patient Access Representative

Purpose of Position:
To obtain accurate and complete patient information and payer verification in a customer-focused manner, to assure expedient care and accurate billing

Description:

• Interview patient and/or patient representative to obtain required information necessary to complete the registration process in the hospital information system and maintains the accuracy, confidentiality and integrity of the automated database.
• Coordinate and communicate accurate and updated registration/admission/pre-admission activities with Medical Records, Care/Case Management, Utilization Management, Physicians' offices, Patient accounts, and any other hospital departments, as may be required, to support the appropriate, accurate, safe and effective patient care.
• Initiate and maintain organized files and records, related to orders, payer authorizations, booking slips, schedules, and others per department procedure.
• Contacts patients, employers, insurers and patient representatives to obtain insurance and other information necessary to secure hospital reimbursement, verifies benefits and pre-certifies all insurance plans to ensure maximum reimbursement to the hospital.
• Verifies benefits, utilizing insurance verification systems. Obtains referrals and authorizations required and documents complete information, along with approved bed status, if applicable, in the computer system. Obtains pre-certifications in a manner to ensure maximum allowable reimbursement to the hospital.
• Maintains a thorough knowledge of departmental policies and procedures to ensure maximum reimbursement to the hospital.
• Attends departmental and other meetings as requested by the immediate supervisor.
• Ensure timely placement of patients in the most effective and appropriate manner. Process admissions, discharges and transfers of all Hospital patients, per department procedures.
• Explain and process payments from patients, which may include but not limited to co-pays, co-insurance, and deductibles
• Follows department procedures related to securing payment information and providing patient receipts.
• Provide information to patient and/or representative on: Health Care Proxy, Advanced Beneficiary Notice, Important Medicare Message (IMM) forms, Financial issues and refers to Financial Counselor if appropriate. Obtain completed forms as available.
• Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers.
• Perform other work-related duties and activities as assigned or requested by manager/supervisor.

Qualifications:

• Ability to read, write and communicate in English at the level of a high school graduate.
• Ability to type at the rate of 25 WPM as demonstrated by a timed test.
• Computer skills to perform the job functions in a satisfactory, accurate and productive manner.
• Successful passage of a Medical Terminology course or successful passage of Medical Terminology challenge exam.
• Ability to work independently and under pressure.

Schedule Details:
24 Hours Per Week, Rotating Nights, 11p-7a, Every Other Weekend & Rotating Holidays

Organization:
Cape Cod Hospital

Primary Location:
Massachusetts-Hyannis

Department:
CCH-Patient Access

Annual/Hourly:
Hourly

Hiring Pay Range:
$20.51 - $33.69