ED Patient Svcs Representative

UPMC; Harrisburg (Dauphin County); On-site; USD 35,000 - 52,000; Full time

Job summary

UPMC is seeking an experienced Patient Access specialist to coordinate all phases of the revenue cycle, from scheduling and registration through denial management. The role requires accurate ADT registration, verification of benefits, patient counseling on coverage and payments, and strict HIPAA compliance.

Strong communication and the ability to work independently in a fast-paced hospital environment are essential.

Qualifications

• High School graduate or equivalent.
• 2 years' healthcare experience or 1 year in medical billing/fiscal setting, or 6 months in a UPMC Patient Access position preferred.
• Medical terminology and knowledge of third-party health care coverage preferred.
• Excellent interpersonal, written and verbal communication skills are required.
• Ability to work independently and handle pressure.

Responsibilities

• Coordinate patient access for all phases of the revenue cycle from scheduling and registration to referral and denial management.
• Reconcile and maintain the First Net Emergency Department Tracking Board and Hospital ADT system.
• Ensure accurate registration into ADT or clinical systems during downtime with monitoring and reconciliation.
• Confirm insurance eligibility and coordinate benefits to support a seamless billing process.
• Counsel patients regarding insurance coverage and financial liability; collect payments at time of service.
• Maintain HIPAA compliance and protect patient confidentiality; obtain required signatures and forms.
• Obtain/update demographic and insurance information; conduct timely bedside patient interviews.
• Support communication with clinical partners to ensure data integrity and information flow.
• Remain calm and professional in stressful situations while prioritizing tasks.

Skills

Interpersonal skills

Written communication

Verbal communication

Work under pressure

Education

High School diploma

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.

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.
• Counsels 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 patientsSupport 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