Patient Access Representative
- Job ID: 63102
- Entity: Newport Hospital
- Location Name: Newport Hospital
- City, State: Newport, RI
- Work Type: PART TIME
- Hours Per Week: 22.00
- Shift: Evening
- Posted Date: 9/26/2024
Summary: Under
the general supervision of the Supervisor and according to established
policies and procedures interviews and registers all patients (Inpatient and
Observation Emergency and Outpatients) to obtain demographic third party
insurance and related financial information and enters to on-line computer
system. Initiates reviews and follows-up on patient accounts to ensure proper
data collection for billing. Verifies all
demographic and insurance information and obtains referrals as required.
Responsibilities: Greets Interviews patient or patient's representative in order to Completes registration and enters all data obtained into Ensures patient is properly identified in system per Registers all patients (Outpatient ED Inpatient and Completes documentation required on financial clearance Utilizes on line tools and/or telephone to verify coverage Identifies primary and secondary insurer. Properly records Gathers paper referrals from patients when required by the Utilizes system to determine self-pay balances for all Uses reference tools to determine the expected payment due Collects co-payments as required per financial clearance or Explains consent financial and insurance forms to patients Verifies and updates all information. Makes bracelets places bracelet on patients Utilizes hospital department scheduling and workflow reports Asks patient for Advance Directive and includes with Explains and has patient sign Advance Beneficiary Notice Completes Distributes financial aid applications when patient lacks May pre-admit/pre-register scheduled outpatients and Contacts patient's to verify demographics obtained at time Verifies patient insurance coverage(s) both primary and Obtains and verifies all other information required to Ensures referrals are obtained and confirms accuracy of the Establishes level of insurance benefits and expected payment Checks outstanding balances incurred for previous services When appropriate medical necessity verifications for May collect prepayments by phone or mail if there is enough Refers insured patients who cannot meet their financial Updates status of financial clearance activities in system. Prepares/assembles all necessary paperwork preparatory to Reviews/corrects third party payer eligibility reports. Completes real time status transfers. At arrival at admission or in the patient's room may Coordinates with Nursing Department to assign patient beds Reviews newly assigned medical record numbers for Attends and participates in staff meetings. May be required as needed to provide coverage to numerous Protects and preserves patients right to privacy and Utilizes department equipment: i.e. fax machine phone visa Performs other related duties as required to support the
and directs all patients families and visitors in a prompt and courteous
manner.
obtain complete and accurate third party health insurance and related
personal/financial information. Follows-up on missing data by interviewing patients families or calling
employers nursing homes and other facilities
hospital computer system. Prepares or
completes records as follows:
department policy. Verifies demographic
and insurance information by asking open-ended questions.
Observation) by entering and/or verifying demographic insurance information
into hospital information system. Upgrades account to an active account status.
reports as indicated by Patient Advocate or Pre-Registration Office.
determine level of benefits and confirm that the primary care physician (PCP)
matches the PCP that is recorded in hospital system. Contacts insurance carrier or company for
missing information when necessary. Notifies Pre-Registration Office if coverage changes from
pre-admit/pre-registration information.
insurance information in system. Completes lien forms upon determination that a
liability exists. Enter financial notes
into system.
payer. Updates with the appropriate documentation. Contacts Financial
Counselor/Pre-Registration Office if the insurance does not verify or if the
patient does not have a referral when required by the payer.
patients.
at time of service. Contacts Patient Financial Advocate to estimate expected
payment on complex cases. Refers patients to Patient Financial Advocates if
patients cannot meet the expected payment according to defined criteria.
as required by third party payor or department policy. This includes cash;
check credit card payments for ambulatory and Emergency services or as
indicated by Patient Advocates. Documents collections in system logs payments provides receipts per
department policy. Completes financial
clearance screens in system.
or designee and provides general hospital information regarding policy and
procedure. Obtains patient signatures on
all required forms to meet established hospital requirements. i.e. Privacy
notice Patient Agreement Important Message from Medicare/Tricare the
Medicare Observation Notice/Moon.
per department policies in accordance with patient identification policy.
to complete daily work. Communicates
with service departments to obtain order information as required. Communicates with Financial
Counselor/Pre-Registration Office to obtain authorizations not obtained at or
prior to time of service
admission paperwork to go to nursing unit provides patients with information
on Advance Directives if one is not prepared.
(ABN) as required.
medical necessity checks utilizing order entry system per hospital policy if
not done during pre-registration process.
evidence of adequate health insurance coverage according to established
criteria. Refers patients to Patient
Financial Advocate to assist patient with applications for medical coverage
(Medicaid RIte Care etc.) or Community Free Service and to establish payment
plans.
inpatients in hospital system.
of scheduling to complete any missing information.
secondary "on-line" or by telephone.
secure payment through sources such as Worker's Compensation MSP Medicare
liability liens etc.
PCP.
for selected services. Determines the
patient's portion of payment when applicable and arrange for payment prior to
the provision of services.
prior to contacting patient and follow collection policy concerning prepayment
prior to the provision of additional services.
services to be provided will be performed by the servicing department and will
also require that ABN's be addressed for payment at the time of
pre-registration.
time before admission or the provision of outpatient services to accomplish the
collection otherwise instruct patient to bring payment at the time of
admission/arrival.
obligations including previously incurred hospital balances current
admission/outpatient expected non-covered charges and ABN's to Patient
Financial Advocates (in accordance with department policy).
the patient's arrival.
complete any missing documentation and paperwork required from patients and/or
family members
in accordance with case management guidelines.
duplication reporting all duplicates on appropriate form.
locations (hospital-based Admitting ED Outpatient and Pre-reg areas to meet
patient/customer needs.
confidentiality.
machine laptop PC and other technology as developed.
operations of the Department.
Other information: BASIC KNOWLEDGE: High school diploma or equivalent. Knowledge of medical terminology third party EXPERIENCE: Customer Service Skills Six to twelve months previous third party billing or WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS: Sitting for long periods of time at a workstation requiring INDEPENDENT ACTION: Perform independently within department policies and
insurance information and standard office computer applications required. Knowledge of third party payer verification
and authorization process preferred. Typing and data entry skills required.
hospital registration experience. Third
party billing knowledge. Data entry
skills and PC experience required.
the continuous use of a computer and telephone. May have to do moderate to excessive walking depending on the location
of the assignment. Ability to lift up to
10 pounds.
practices. Refer specific complex
problems to supervisor where clarification of departmental policies and
procedures may be required.
Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Lifespan is a VEVRAA Federal Contractor.
Location: Newport Hospital USA:RI:Newport
Work Type: Part Time
Shift: Shift 2
Union: Non-Union