This position is responsible to conduct a comprehensive registration with minimal assistance, in person or by phone. This includes identifying all potential payer sources, including federal, state and county assistance programs, which will ensure reimbursement for the services being rendered. Whenever possible, such screening will be done prior to admission. The incumbent is responsible to ensure this process is expeditious, non-imposing and insurance authorizations completed meeting payer requirements. This position is accountable for timely coordination and accurate relay of information pertaining to patient admissions and insurance authorizations and potential denials by payers.
This position takes initiative to overcome roadblocks and prioritize workload, ensuring that accounts are financially secured and analyzed to ensure that all delays are identified and communicated to the appropriate personnel. The incumbent must use diplomacy in communicating effectively to patients, guardians, family members, physicians and co-workers. In addition, the incumbent is responsible to coordinate with the interdisciplinary teams to ensure a seamless registration process. The incumbent will be looked to as a primary resource for patient de-escalation and service recovery.
The responsibilities of the Patient Access Representative Senior includes but is not limited to the following:
• Performing technical aspects of work (80%) within team area of responsibility while prioritizing time (20%) to allow for:
• Developing team members through group, as well as one-on-one, training and in-services.
• Facilitating, implementing, monitoring, and appropriately reacting to quality assurance mechanisms. (JACHO)
• Monitoring and developing workflows to improve Patient Experience.
• Developing and revising procedures relevant to the assigned area, coordinated with other Patient Access teams.
• Conducting registration audits and sharing results with representatives and department leadership; works with representatives to improve performance as necessary.
• Working with Patient Access Leadership to resolve operational issues.
• Communicating and tracking of progress towards meaningful goals.
• Ensuring patient financial liabilities are being properly estimated and provided to the patient. Produces education for Patient Access personnel to improve on financial collection techniques.
• Participating in and/or assisting with quality management processes.
• Working with Patient Access Leadership on department projects.
• Acting as a resource for day-to-day operational questions.
• Serving as customer service resource for walk-in patients in hospital lobby/patient registration area.
• Maintaining a thorough understanding of federal and state regulations, payer requirements, and third party financial assistance programs.
• Having sufficient understanding of insurance protocols for referrals, co-payments, deductibles, allowances, etc., and analyzing information received to determine patients’ out-of-pocket liabilities.
• Training and performing on-boarding of newly hired employees.
The position is required to meet goals and productivity standards set by management. This includes performing quality assurance controls to ensure the final product produces a clean claim and meeting collection goals. This position also performs other duties as assigned by their direct and indirect supervisor / manager / director.
This position is expected to show through their actions the highest level of professionalism in accordance with Renown’s values of Integrity, Collaboration, Caring, and Excellence.
This position does not provide patient care.