Patient Access Representative

Job Summary:

As a Patient Access Representative, you will be responsible for registering patients in a professional and courteous manner.

This role includes conducting patient/guarantor interviews, explaining hospital policies, and verifying financial and demographic information for accurate documentation.

You will work directly with patients, ensuring that all necessary authorizations and pre-certifications are obtained to meet individual payor requirements.

Your role is vital in providing a smooth and welcoming experience for patients.

Education:


* High School diploma or equivalent required


* Some college coursework, Certified Patient Account Technician certification, or medical terminology course preferred

Licenses and Certifications:


* Must successfully complete and maintain LA City Fire Card certification at the time of hire or within the first 30 days of employment.


* Must successfully complete and maintain certification for Mgmt.

of Assaultive Behavior (ex.

CPI- Non-violent Crisis Intervention) within 30 days of employment.  

Experience:


*
+ Minimum two (2) years of experience in healthcare, insurance, or a related field.
+ Experience in an inpatient or outpatient admissions setting or a physician’s office is preferred.
+ Knowledge of patient accounting, insurance payor systems, and medical terminology.
+ Strong communication skills, both written and verbal, to interact with patients, payers, and hospital staff.
+ Ability to work both independently and as part of a team.
+ Computer literacy required.
+ Bilingual (Spanish) preferred.

 Responsibilities:


* Interview and register patients in compliance with hospital policies.


* Ensure adherence to EMTALA rules and regulations during emergency department registration.


* Accurately input demographic and financial data into the system to ensure proper revenue routing.


* Validate and update patient information as needed, maintaining a 97% accuracy level.


* Scan all necessary documents, including insurance cards, personal identification, and driver’s licenses.


* Obtain insurance information and verify patient coverage, ensuring accounts reflect correct details.


* Secure pre-certifications/authorizations in accordance with payor protocols.


* Collect deposits, copays, deductibles, and payments for non-covered services.


* Utilize tools to ensure compliance with payor payment authorization protocols.


* Assist patients with completing financial packets and establishing financial arrangements according to hospital policies.


* Complete the Advanced Beneficiary Notification for Medicare patients as required.


* Record and maintain comments in the system to ensure accurate follow-up.


* Assist the admitting supervisor and director with patient-related duties as needed.


* Manage patient room assignments in collaboration with nursing ...