Patient Access Representative Senior - Admitting in New Braunfels, TX

Job Description | Job Attributes

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External Applicant Current Associate

Summary:

Patient Access representatives facilitate a welcome and easy access to the facility and are responsible for establishing an encounter for any patient who meets the guidelines for hospital service. Patient Access staff ensures that all data entry is accurate including demographic and financial information for each account. Patient Access has numerous procedural requirements including data elements, insurance verification, authorization for services, and collections for all patient portions including prior balances. Patient Access staff is responsible for the successful financial outcome of all patient services. Patient Access is responsible for ensuring the hospital maintains compliance with Federal regulations, JCAHO, and Department of Health and Hospital compliance standards. Patient Access communicates directly with patients and families, physicians, nurses, insurance companies and third party payers. This position requires professional appearance, and behavior, good communication and effective organizational skills. Patient Access representatives require dependability, flexibility, and teamwork.

This advanced level position is designed to promote the demonstrated knowledge and competency of Patient Access duties in all areas, including a demonstrated ability to use good judgment in making independent decisions to resolve customer issues in all routine operations 

  Responsibilities:

• Accurately inputs all required data elements for scheduling and registration, including patient demographic, financial information, guarantor information, and relevant notes associated with the encounter.
• Verifies insurance eligibility and obtains necessary authorizations for services rendered.
• Calculates and collects the estimated patient portion based on benefits and contract reimbursement as well as prior balances.
• Performs financial assessment for appropriate program assistance.
• Communicates the purpose of and obtains patient/legal guardian signatures on all necessary hospital documents.
• Represents the Patient Access department in a professional, courteous manner at ALL times.
• Required to assist the hospital in the event of an internal or external disaster.
• Supports the flexible needs of the department to accommodate patient volume in all areas of the hospital. This may require assignment to another area of the department, and shift change.
• Serves as a point of primary contact for patient complaints/customer issues.
• Supports the department in achieving established performance targets.
• Completes required training as needed and as mandated.
• Participates in/assists with performance improvement initiatives and demonstrates an understanding and compliance of all department policies and procedures.
• Maintains the team discipline of following all elements of established standard processes
• Works with HPWT (High Performance Work Teams) to maintain an efficient, clean, and orderly workplace using 5S principles and practices once implemented in the work unit.
• Coordinates, communicates, and assists in monitoring work flow and work tasks necessary to manage fluctuating volumes.
• Provides feedback to the team to help identify educational needs, and mediation needs by reporting IPOs (issues, problems, and opportunities).
• Demonstrates competence to perform assigned responsibilities is a manner that meets the population-specific and developmental needs of the members served by the department.
• Appropriately adapts assigned assessment, treatment, and/or service methods to accommodate the unique physical, psychosocial, cultural, age-specific and other developmental needs of each member served.
• Takes personal responsibility to ensure compliance with all policies, procedures and standards as promulgated by state and federal agencies, the hospital, and other regulatory entities.
• Performs all duties in a manner that protects the confidentiality of patients and does not solicit or disclose any confidential information unless it is necessary in the performance of assigned job duties.
• Demonstrates adherence to the CORE values of Santa Rosa Health Care.
• Performs other duties as assigned.

Requirements:

Education

• High school diploma or equivalent required.

Experience

• Two years experience in Patient Access, hospital registration, medical office, billing/collection functions, or a comparable customer service related position preferred.

Licenses, Certifications, or Registrations

• Certified Healthcare Access Associate (CHAA) through National Association of Healthcare Management (NAHAM) completed within first 6 months of employment and no later than associates first anniversary. Continued employment at PAR II level hinges on passing this certification within stated timeframe and the bi-annual maintenance of certification.

Work Type:

Full Time