Children's National Medical Center
Patient Access Representative (Part-time | 8 Hours per week)
Children's National Medical Center, Rockville, Maryland, us, 20849
Job Description - Patient Access Representative (Part-time | 8 Hours per week) (240000HR)DescriptionThis position reports to the Patient Access Supervisor or Manager. Provide patient services and administrative support in ancillary operations. Interact with parents, patients, physicians, and other staff under moderate supervision in a courteous manner. Provide assistance to other employees within their department as well as other departments. Collect and verify all demographic information to ensure accuracy. May provide required notification of scheduled and unscheduled services according to insurance provider requirements. May be responsible for scheduling patients for ancillary appointments. Position may be required to float to ancillary patient access areas for coverage (ED, RAD, LAB, AMSAC etc.). Next step in career ladder is Senior Patient Access Rep.QualificationsMinimum EducationHigh School Diploma or GED (Required)
Minimum Work Experience2 years Related experience (Required)
Required Skills/KnowledgeBroad knowledge in administrative processes, customer service skills. Computer knowledge necessary. Microsoft Office experience preferred (Word & Excel). Complete Patient Access training curriculum and pass all competency assessments. The ability to type a minimum of 35 words per minute is required.Functional AccountabilitiesPatient ServicesDemonstrate accuracy of scheduling patients using the applicable scheduling system for the department. Verify applicable charge codes correspond with diagnostic codes. Enter information into the billing/registration system.Complete computer-aided, online registration screen with parent/guardian via telephone or in person in a professional & courteous manner.Collect accurate demographic and insurance information. Update systems as needed in accordance with department standards for registration accuracy. Complete bedside registration for ED patients.Reschedule appointments for patients who did not show or for the ancillary services cancellations by providers/technologist. Schedule follow-up appointments at check out if applicable.Greet patients and parents courteously. Arrive patients in the appropriate system based on department policy.Obtain required consents for department & ensure distribution of compliance-related materials (i.e. HIPAA Privacy Notice, Patient Rights). Obtain a copy of insurance card and photo ID to be stored in the medical record (copy or scan activity required). Ensure applicable insurance company and CNMC HIM department receive copies of appropriate forms/documentation. Complete all documentation in accordance with department policy and procedure.Respond to patient portal work lists (i.e. appointment requests, fax queues, email requests, etc.). May include messaging center work lists in the future.Information VerificationVerify insurance eligibility using applicable eligibility system. Ensure managed care carve-outs (lab and radiology carve-outs) are adhered to.Advise leadership of any authorization issues at the time of check-in. Identify surgeries/diagnostic testing without an authorization. Contact provider’s office or scheduling coordinator to address the issue timely without delaying patient care.Notify parents of the need for completed insurance referral form or pre-authorization prior to scheduled/unscheduled appointments.Discuss co-payment, deposits, payment in full, or past due balance collections with parents in a professional & courteous manner.Counsel parents or refer parent to Financial Information Center (FIC) for establishing payment schedule or method of payment.Verify insurance information is complete prior to the procedure and collect and verify pre-authorization/referral information: goal is to obtain authorizations 5 days in advance of service.Utilize all systems where patient information may be stored (EPRS, SCI, Cerner, IDX, McKesson, etc.) to verify that systems are in sync.Cash CollectionCollect and record co-payments, deposits, and payments in full and provide the payer with a receipt. Responsible for helping the department meet 85% of the collection target for the department.Maintain departmental requirements regarding cash controls and collections.Billing PreparationFor ancillary services ensure all applicable orders/scripts/referrals are obtained prior to services being rendered.Appropriately clear all walk-in and ensure scheduled/unscheduled appointments are linked to the scheduling system.Responsible to ensure daily quality review of all registration processed real-time.Office SupportAnswer telephone and address caller needs appropriately. Avoid transferring calls for better service to families. Meet department standards relative to ACD policies if applicable. Manage voicemail messages within the same business day.Distribute mail. May work returned mail as needed.All staff are responsible for information distributed via e-mail. Staff should check work email a minimum of 3 times daily and respond to inquiries within 24 hours (or next business day).Maintain office files and office supplies at PAR levels.Maintain clean reception area and workspace.Other support as needed.Organizational AccountabilitiesAnticipate and respond to customer needs; follow up until needs are met.Demonstrate collaborative and respectful behavior.Partner with all team members to achieve goals.Receptive to others’ ideas and opinions.Contribute to a positive work environment.Demonstrate flexibility and willingness to change.Identify opportunities to improve clinical and administrative processes.Make appropriate decisions, using sound judgment.Use resources efficiently.Search for less costly ways of doing things.
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Minimum Work Experience2 years Related experience (Required)
Required Skills/KnowledgeBroad knowledge in administrative processes, customer service skills. Computer knowledge necessary. Microsoft Office experience preferred (Word & Excel). Complete Patient Access training curriculum and pass all competency assessments. The ability to type a minimum of 35 words per minute is required.Functional AccountabilitiesPatient ServicesDemonstrate accuracy of scheduling patients using the applicable scheduling system for the department. Verify applicable charge codes correspond with diagnostic codes. Enter information into the billing/registration system.Complete computer-aided, online registration screen with parent/guardian via telephone or in person in a professional & courteous manner.Collect accurate demographic and insurance information. Update systems as needed in accordance with department standards for registration accuracy. Complete bedside registration for ED patients.Reschedule appointments for patients who did not show or for the ancillary services cancellations by providers/technologist. Schedule follow-up appointments at check out if applicable.Greet patients and parents courteously. Arrive patients in the appropriate system based on department policy.Obtain required consents for department & ensure distribution of compliance-related materials (i.e. HIPAA Privacy Notice, Patient Rights). Obtain a copy of insurance card and photo ID to be stored in the medical record (copy or scan activity required). Ensure applicable insurance company and CNMC HIM department receive copies of appropriate forms/documentation. Complete all documentation in accordance with department policy and procedure.Respond to patient portal work lists (i.e. appointment requests, fax queues, email requests, etc.). May include messaging center work lists in the future.Information VerificationVerify insurance eligibility using applicable eligibility system. Ensure managed care carve-outs (lab and radiology carve-outs) are adhered to.Advise leadership of any authorization issues at the time of check-in. Identify surgeries/diagnostic testing without an authorization. Contact provider’s office or scheduling coordinator to address the issue timely without delaying patient care.Notify parents of the need for completed insurance referral form or pre-authorization prior to scheduled/unscheduled appointments.Discuss co-payment, deposits, payment in full, or past due balance collections with parents in a professional & courteous manner.Counsel parents or refer parent to Financial Information Center (FIC) for establishing payment schedule or method of payment.Verify insurance information is complete prior to the procedure and collect and verify pre-authorization/referral information: goal is to obtain authorizations 5 days in advance of service.Utilize all systems where patient information may be stored (EPRS, SCI, Cerner, IDX, McKesson, etc.) to verify that systems are in sync.Cash CollectionCollect and record co-payments, deposits, and payments in full and provide the payer with a receipt. Responsible for helping the department meet 85% of the collection target for the department.Maintain departmental requirements regarding cash controls and collections.Billing PreparationFor ancillary services ensure all applicable orders/scripts/referrals are obtained prior to services being rendered.Appropriately clear all walk-in and ensure scheduled/unscheduled appointments are linked to the scheduling system.Responsible to ensure daily quality review of all registration processed real-time.Office SupportAnswer telephone and address caller needs appropriately. Avoid transferring calls for better service to families. Meet department standards relative to ACD policies if applicable. Manage voicemail messages within the same business day.Distribute mail. May work returned mail as needed.All staff are responsible for information distributed via e-mail. Staff should check work email a minimum of 3 times daily and respond to inquiries within 24 hours (or next business day).Maintain office files and office supplies at PAR levels.Maintain clean reception area and workspace.Other support as needed.Organizational AccountabilitiesAnticipate and respond to customer needs; follow up until needs are met.Demonstrate collaborative and respectful behavior.Partner with all team members to achieve goals.Receptive to others’ ideas and opinions.Contribute to a positive work environment.Demonstrate flexibility and willingness to change.Identify opportunities to improve clinical and administrative processes.Make appropriate decisions, using sound judgment.Use resources efficiently.Search for less costly ways of doing things.
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