Patient Access Representative (Hamburg, Per Diem)
St. Luke's University Health Network, Hamburg, PA, United States
St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.
JOB SUMMARY
The Patient Access Representative I is responsible for the entire scope of the registration process for patients seen at St. Luke's University Health Network, in outpatient and/or Emergency Department locations. This includes, but is not limited to, correctly identifying patients, transcribing orders, completing registration screens, entering diagnosis and provider information, verifying insurances, point of service cash collections, work queues, etc. A Patient Access Representative I is required to have excellent customer service skills and exhibit PCRAFT values at all times with internal and external customers. Patient Access Representative I communicates/coordinates with SLPG practices, clinical/diagnostic departments, and various revenue cycle departments to ensure excellent patient experience, clean claim submission, and payment for services. May require occasional travel between campuses or regional locations. Required to be cross-trained in all departments at campus or within region.
JOB DUTIES AND RESPONSIBILITIES:
Responsible to correctly identify/validate the choosing of patients in hospital information system to maintain the integrity and accuracy of electronic medical records. Identify and report any instances of possible identify theft situations to clinical department and leadership for appropriate escalation.
Maintain knowledge and education of network policy on Patient Identification including Mark for Merge, Chart Corrections, and Patient Look-Up.
Responsible for the patient registration (pre-reg and post-reg needs) including all of the following: demographics, emergency contact, transcribing diagnostic orders, primary care and referring provider, diagnosis, insurance and guarantor verification, real time insurance eligibility, point of service cash collections. This also includes patient, account, and claim edit level work queue errors related to registration. Can require contacting provider office, reviewing patient medical chart for diagnosis and medical necessity information.
Required to cross train in all areas of location or region. Campus locations must be cross trained in outpatient and Emergency Department areas. Outpatient (off-campus) locations must be cross trained for all locations if any different nuances.
Greets/directs patients and visitors for the entire facility. Always provides friendly and courteous service to community and co-workers. Responsible for monitoring and enforcing visitor policy for the entity (if applicable).
Answers internal and external calls on main department/facility line and dispenses appropriate information and answers questions regarding the facility and its services.
Promotes and helps increase usage of MyChart patient portal and patient self-service capabilities to ensure patients are personally engaging in their health care.
Responsible for overseeing and assisting patients with Welcome Kiosk and On My Way technology at network locations. Consists of self-scheduled patients online and monitoring the arrival process and patient’s journey throughout their visit.
Responsible for contacting the SLPG practice or Network Prior Authorization Department to obtain required insurance referrals and pre-certs when not previously documented in chart prior to service to decrease denials for no authorization.
Must obtain Medical license Number, NPI and UPIN via appropriate website for all new provider entries for outpatient services to ensure results are routed accurately and claim submission/payment.
Must maintain knowledge of current insurance and government regulations regarding billing and registration. Includes providing estimates to self-pay patients prior to service and notifying out of network patients prior to service and providing all applicable options.
Verifies all insurance/self-pay patients through online eligibility or via contacting payer directly (phone or website).
Responsible for identifying, collecting, and recording point of service cash collections prior to or at time of service. Posting credit card payments in Epic or other application, collecting cash, closing the daily cash drawer, and preparing deposit for transport.
Responsible to accurately transcribe all outpatient written diagnostic testing orders, and process electronic diagnostic orders. Includes verifying order/script contains all required information (test, diagnosis, provider signature). Must also ensure testing is being performed at the requested due date assigned by provider.
Responsible for verifying if proper prep instructions were followed for patient (barium, fasting, etc.) prior to service to expedite any issues for clinical department or patient.
Maintain a working knowledge of all applicable policies and procedures pertaining to Patient Access and Administrative Policies pertaining to job role.
Complete all required competencies within learning management system and required trainings as assigned by Patient Access leadership or Revenue Cycle Operational Improvement Team (monthly competencies/policy review).
Responsible for sign in registry for vendors and clergy, providing churches and clergy information when needed (campus entities).
Responsible to immediately resolve minor patient/visitor issues and inform department leadership, or Nursing Supervisor, and Security of any significant patient and visitor complaints/issues.
Responsible for completing government forms including Important Message from Medicare, and Medicare Outpatient Observation Notice signature processes on inpatient clinical units (campus entities).
Responsible to collect all loose clinical paper documentation. Analyze, sort and batch scan to Health Information Services twice daily (campus entities)
PHYSICAL AND SENSORY REQUIREMENTS:
Sitting/standing up to 8 hours per day, 4 or more hours at a time. Frequent use of hands/fingers for data entry. Frequently walking and ability to push up to 250 pounds in a wheelchair. Ability to occasionally carry or lift up to 15 pounds. Hearing as it relates to normal conversation. Seeing as it relates to general vision.
MINIMUM QUALIFICATIONS EDUCATION:
High school graduate or equivalent required. Certificate/Degree in health care related field preferred.
TRAINING AND EXPERIENCE:
Excellent customer service and interpersonal skills required. General computer experience and ability to type fluently, accurately, and quickly required. Insurance background preferred. Knowledge of medical terminology preferred. Previous medical administrative experience and/or health care related education courses preferred. Knowledge of health information system (epic) preferred.
Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!