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Patient Access Representative in Southfield, MI at Oakland Regional Hospital

Date Posted: 8/31/2018

Job Snapshot

Job Description

Shift Time: Days
Shift Length: 8 hours
Standard Hours Per Week: 40 hours/week

Role/Position Definition:

The Patient Access Representative is responsible to accurately collect and analyze all required demographic, insurance, financial and clinical data elements necessary to register patients. They are responsible for the provision of routine patient access activity to facilitate efficient operations, expeditious reimbursement and optimal consumer satisfaction and to promote teamwork. They are responsible to further the mission of Oakland Regional Hospital. They are responsible to consistently demonstrate the core values of Oakland Regional Hospital. They are responsible to perform his/her duties in accordance with regulatory compliance requirements and the Hospital’s Code of Conduct. Due to financial and clinical responsibilities this role is dual reporting.

Duties & Responsibilities:

A. Strong communication, time management, organization, and customer service skills are necessary in order to excel in this position.
B. Assumes any and all clerical duties and responsibilities as necessary.
C. Assists in ordering and stocking clerical supplies.
D. Assists in maintaining cost effectiveness by preventing waste of supplies.
E. Ability to work in a high volume environment.
F. Develop and maintain a good working rapport with interdepartmental personnel as well as other department areas within the facility.
G. Verifies necessary information (i.e. procedure, patient demographics and insurance coverage) and records in the electronic medical record, (i.e. Healthland). Updating demographic information as needed.
H. Identifying a source of payment, obtaining sufficient information to permit reimbursement, ensuring the information is complete and accurate and interfacing with insurers and members of the healthcare team.
I. Verifies insurance benefits and/or referral and obtain pre-certification/authorization for diagnostic procedures.
J. Ability to assess the patient’s financial status and coverage provisions prior to scheduling procedures and routinely communicates with manager/director regarding collection concerns, questionable coverage and benefits.
K. Knowledge of managed care and third party payer benefit designs and reimbursement requirements.
L. Charge Entry/Audit/Follow-up for all procedures performed at the unit/site.
M. Relays necessary information as required with Radiology Manager and Director of Patient Access
N. Considers patient rights in performance of job duties and responsibilities.
O. Interacts appropriately with various age groups.
P. Accurately interprets age-specific patient responses to questions and instructions.
Q. Considers age-specific patient requirements when responding to emergency situations.
R. Reviews forms for patient signature; obtains forms or signature(s) as required.
S. Provides information to the patient's family in the waiting area according to facility policy.
T. Monitors the reception and waiting areas.
U. Coordinates reception area activities for effective communication throughout the facility.
V. Answers telephone courteously.
W. Receives and relays messages effectively.
X. Contributes to the progress and development of the approved Quality Management Program.
Y. Understanding of medical terminology, HIPAA privacy laws.
Z. Understanding of CPTs (Current Procedural Terminology)
AA. Prepares statistical reports as required.
BB. Identifies procedural problems in the department and makes adjustments as necessary.
CC. Maintains compliance with Oakland Regional Hospital’s policies, procedures and accrediting bodies.
DD. Communicates effectively with patients, visitors, physicians, and co workers.
EE. Interactions are respectful and courteous.
FF. Keeps the office neat and orderly.
GG. Adheres to safety policies and procedures in performing job duties and responsibilities.
HH. Safety problems are identified and corrective actions taken.
II. Reports observed or suspected violations, hazards, and noncompliance according to Facility policy.
JJ. Maintains and promotes professional competence through continuing education and other learning experiences.
KK. Seeks new learning experiences by accepting challenging opportunities and responsibilities.
LL. Objectively evaluates suggestions or criticisms and attempts to improve performance or seeks further guidance, as needed.
MM. Attends and actively participates in meetings, committees, inservices, workshops, seminars, and conferences according to job responsibilities and Facility requirements.
NN. Performs all other duties as assigned.

Job Requirements

Qualifications/Position Requirements:

A. Education/Experience:

  • High School Diploma or G.E.D. required.
  • Office experience in a healthcare setting preferred.

B. Licensure/Certification:

  • BLS certification preferred

C. Knowledge, Skills and Abilities

  • Strong communication and organization skills.
  • Proficient reading and writing skills.
  • Proficient in computer usage (i.e. Windows-based operating system, Microsoft Office).
  • Proficiency in the use of general office equipment (i.e. copier, facsimile, telephones).
  • Proficient knowledge of Heath Information Systems (i.e. Healthland).
  • Knowledge of medical terminology.
  • Knowledge human anatomy and physiology.

Work Environment:

A. Prolonged sitting and frequent movement possible.
B. Ability to lift and maneuver equipment and supplies.
C. Detail oriented with the ability to multi-task.
D. Regular use of the computer
E. Exposure to patient care areas.
F. Frequent public contact.