Patient Access Representative I

• Process - Maintains the best practice routine per department guidelines.
• Daily work queues are maintained at acceptable levels according to department policies.
• Correspondence worked daily to current.
• Registration - Performs financial clearance process by interviewing patients and collecting and recording all necessary information for pre-registration and registration of patients.
• Ensures that proper insurance payer plan choice and billing address are assigned in the automated patient accounting system.
• Verifies relevant group/ID numbers.
• Completes the registration process according to established policies and procedures.
• Informs families with inadequate insurance coverage regarding financial assistance through government and financial assistance programs.
• Performs initial financial screening and refers accounts for financial counseling and/or appropriate eligibility assessments.
• Ensures all referrals and treatment authorizations for all patient types have been obtained according to the outlined requirements.
• If not obtained, contact payers for approvals.
• Completes initial medical necessity checks.
• Refers to the designated area if medical necessity fails or if referrals /authorizations are denied.
• Communication & Miscellaneous - Advises next-level leader of possible postponement or deferrals of any elective/non-emergent admission which has not been approved prior to service date.
• Maintains accurate files for pre-processing information as required.
• Investigates, resolves, and documents patient problems in a timely and efficient manner.
• Maintains accurate files for pre-processing information.

EDUCATION:

• High School Graduate, or equivalent  

LICENSURE, REGISTRATION, CERTIFICATION:

• N/A  

EXPERIENCE:

• 1-2 years of health care or related experience preferred.