ED Patient Svcs Representative

UPMC; Harrisburg (Dauphin County); On-site; USD 22,000 - 33,000; Full time

Job summary

UPMC is seeking a Patient Access professional to coordinate all phases of the revenue cycle from scheduling and registration through referral and denial management.

The role requires accurate registration, insurance verification, and patient financial counseling to support seamless billing and compliance with HIPAA regulations. You will work closely with clinical partners and care teams, including evenings and weekends as needed.

Qualifications

• Completion of High School diploma or equivalent.
• 2 years' experience in a healthcare or 1 year in a medical/billing/fiscal setting or 6 months in a UPMC Patient Access position preferred.
• Medical Terminology, third party health care coverage experience and strong understanding of managed care regulations are preferred.

Responsibilities

• Reconcile and maintain the First Net Emergency Department Tracking Board and Hospital ADT system.
• Ensure accurate registration into hospital ADT and/or clinical system during downtime with monitoring and reconciliation of every patient.
• Serve as central resource for all ADT registration and problem resolution during evenings, weekends and holidays.
• Confirm insurance eligibility and coordinate benefits to support a seamless billing process.
• Counsel patients regarding insurance coverage and expected financial liability.
• Collect and record patient payments including co-pays, co-insurance, and deductibles on the day of service.
• Maintain HIPAA-compliant handling of patient information and communications.
• Work with clinical partners to ensure data integrity and timely information sharing.

Skills

Interpersonal skills

Communication skills

Customer service

HIPAA compliance

Education

High School diploma or equivalent

Job description

Job Summary

Functions under the general direction of department leadership in Patient Access. Coordinates patient access for all phases of the revenue cycle from scheduling and registration up to and including referral and denial management.

Job Summary

Functions under the general direction of department leadership in Patient Access. Coordinates patient access for all phases of the revenue cycle from scheduling and registration up to and including referral and denial management.

Responsibilities

• Responsible for reconciliation and maintenance of First Net Emergency Department Tracking Board and Hospital ADT system.
• Accountable for accurate registration into hospital ADT and/or clinical system during system downtime with monitoring and reconciliation of every patient for accuracy.
• Central Resource for all ADT registration and problem resolution during evenings, weekends and holidays.
• Confirms insurance eligibility, accountable for third party reimbursement and coordination of benefits to support a seamless billing process.
• Counsel patients regarding insurance coverage and expected financial liability.
• Collects and records patient payments including co-payments, co-insurance, and deductibles on the day of service.
• Provides a warm greeting for all patients
• Support and contribute to UPMC core values and guiding principles of Your Care. Our Commitment and abide by all UPMC departmental policies, procedures and goals in the process of performing all job responsibilities. Incorporates acts of dignity and respect in daily interactions.
• Proper patient identification to start clinical record (utilizing biometrics if applicable)
• Facilitator of financial gatekeeping with clinical partners.
• Accountable for maintaining a close working relationship with clinical partners to assure continual open communication with pertinent information obtained such as any alias name changes, information blocks to prevent release of information, and behavioral health insurance payors to assure timely data integrity of accounts.
• Obtains or updates necessary demographic and insurance related information.
• Works independently to perform a timely patient interview and registration for services at the bed side.
• Generates and completes all applicable forms and necessary communications. Obtains applicable signature for consent to treat and financial responsibility, along with signatures on any required forms, while following all HIPAA rules and regulations and maintaining patient confidentiality.
• Ability to remain calm and professional when faced with stressful situations, while simultaneously prioritizing all work activities.
• Anticipates and responds to inquiries from patients, visitors, hospital personnel, government agencies, etc. under all conditions and circumstances.
• Completion of High School graduate or equivalent.
• 2 years' experience in a healthcare or 1 year in a medical/billing/fiscal setting or 6 months in a UPMC Patient Access position preferred.
• Medical Terminology, third party health care coverage experience and strong understanding of managed care regulations are preferred.
• Experience with personal computer based applications, other various office equipment and proficient typing skills.
• Excellent interpersonal, written and verbal communication skills are required.
• Initiative to work productively with minimal supervision. Able to work well under pressure.

Licensure, Certifications, and Clearances

• Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran