Patient Access Rep I

capitalhealth; Pennington (NJ); On-site; USD 25,000 - 31,000; Full time

Job summary

Capital Health is hiring a Registration Clerk to accurately register patients, verify benefits, and collect necessary information for claims processing. You will follow insurance guidelines, obtain referrals when needed, and collaborate with departments to ensure data accuracy and timely reimbursement.

A positive, patient-centered approach and basic computer skills are required. The role supports a busy outpatient environment with 40-hour work weeks and a pay range of $18.21–$22.74 per hour.

Qualifications

• One year experience in healthcare or customer service preferred.
• Knowledge of medical terminology and medical insurance is a plus.
• Strong verbal and written communication; able to work independently or in a team.

Responsibilities

• Verify and collect patient demographics and insurance information during registration.
• Follow payor requirements and obtain referrals and authorizations when needed.
• Assist patients respectfully with registration and privacy compliance.
• Collaborate with departments to secure required information for reimbursement.
• Perform chart audits and ensure accurate data entry into EMR.

Skills

Customer service

Communication

Interpersonal skills

Basic computer skills

Education

High school diploma or equivalent

Tools

Medical terminology

Job description

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Pay Range:

$18.21 - $22.74

Scheduled Weekly Hours:

40

Position Overview

SUMMARY (Basic Purpose of the Job)

Registers patients accurately, efficiently and professionally to ensure database integrity and facilitate claims processing. Applies financial screening guidelines to ensure collectable accounts. Utilizes standards, guidelines, and written procedures for performing registration functions.

MINIMUM REQUIREMENTS:

• Education: High school diploma or equivalency.
• Experience: One year experience in healthcare setting or customer service. Medical terminology and medical insurance knowledge preferred.
• Knowledge and Skills: Strong customer service skills. Excellent verbal and written Communication skills. Strong interpersonal skills.
• Special Training: Basic computer skills.
• Mental, Behavioral and Emotional Abilities: Ability to work independently and as a team. Maintains composure in high pressure or fast paced environment.
• Usual Work Day: 8 Hours

ESSENTIAL FUNCTIONS

• Follows all payor requirements for both in/out of network insurance plans and identifies needs for referrals and precertification either electronically or by telephone according to department procedures and guidelines. Performs verification of benefits on all patient encounters. Audits chart for accuracy.
• Follows computer system, internet-based third-party insurance applications, department operational procedures and departmental training guidelines to obtain accurate demographic, diagnosis, authorizations/referrals and insurance information on each registration.
• Demonstrates service excellence by professionally assisting patients and customers with the utmost respect in a friendly caring manner.
• Works collaboratively with other departments, physicians and physician office staff to obtain essential registration information such as insurance authorization, referrals, diagnosis, and scripts, to secure financial reimbursement and customer/patient satisfaction
• Complies with department procedures and regulatory guidelines for Medicare Secondary Payer, Medicare Medical Necessity Regulations, Collection of co-pay, Advance Beneficiary Notice, Advance Directives, and Patients' Rights.
• Registers established goal of minimum required patients per employee shift as measured by productivity reports. Correctly identifies a patient according to policy, completes all patient registration types by collecting and entering accurate patient demographics, physician information, insurance information and valid registration specific codes.
• Obtains all necessary signatures. Assures insurance information is verified, and authorization is obtained if not done prior to service, essential registration forms are scanned into Electronic Medical Record, and chart follow up is performed as needed.
• Ascertains and records appropriately the difference between primary care physician, referring physician and attending physician.
• Displays comprehension of identifying participating CH insurance plans and ability to identify nonparticipating plans.
• Utilizes Insurance Card Database and/or Insurance Verification guidelines.
• Follows Financial Screening and Self Pay Procedure with regards to referrals for Medicaid and Charity Care.
• Attends all mandatory department meetings.
• Supports and participates in department performance improvement initiatives.
• Performs other duties as needed.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

• Frequent physical demands include: Sitting , Standing , Walking , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion
• Occasional physical demands include: Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl
• Continuous physical demands include: Talk or Hear
• Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.
• Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Depth Perceptio