Patient Access Rep I - Emergency Dept FT Eves

Torrance Memorial Medical Center; Torrance (CA); On-site; USD 80,000 - 100,000; Full time

Job summary

A leading healthcare facility is seeking a Patient Access Representative to ensure financial stability by accurately entering patient data for medical billing. This role involves collecting necessary information, validating insurance, and providing excellent customer service to patients and families. The ideal candidate will have experience in healthcare or customer service and a strong understanding of insurance processes.

Qualifications

• 1 year of experience in healthcare revenue cycle or customer service.
• Basic working knowledge of Medicare and other insurance programs.
• Ability to explain department documents to patients.

Responsibilities

• Collects required data for patient intake and billing.
• Validates patient eligibility and insurance verification.
• Greets customers and answers phone calls courteously.

Skills

Data Entry

Customer Service

Insurance Verification

Patient Interaction

Job description

Under direct supervision, this position performs tasks to ensure financial stability by entering patient data accurately, timely, and efficiently in order to create a claim to bill for medical services provided.

Core Competencies

1. Collects all required data elements to complete the intake process within the hospital revenue cycle system.
2. Utilizes hospital bed board/patient tracking system to track and arrange proper placement of patient on nursing units.
3. Maintains basic working knowledge of all sponsored programs such as Medicare, Medi-Cal, Tricare, and all other payers; as well as contracted insurance payers and authorization requirements.
4. Maintains proficient working knowledge of Medicare Secondary Payor Questionnaire policy and procedures.
5. Validates patient eligibility, benefits, and medical group affiliation, and obtains insurance verification and notification as needed. Validation may be performed via telephone, payer website, or hospital registration application.
6. Demonstrates basic working knowledge of all department/regulatory generated documents and can explain their meaning to patients, obtaining appropriate initials/signatures.
7. Bands patients appropriately and distributes labels/face sheets as necessary during registration.
8. Collects and returns patient valuables in accordance with department procedure in designated areas.
9. Creates estimates, requests, and collects patient financial responsibility payments for hospital services.
10. Greets customers promptly, ensuring they are taken care of in a timely and professional manner.
11. Answers the telephone courteously within three rings, identifies self and department, routes calls, ascertains needs, and takes accurate messages as appropriate.
12. Complies with departmental policies and procedures, demonstrating basic working knowledge and referencing policies to explain to patients, families, physicians, and staff.
13. Enters data related to HAV bed polls and notifies administrative house supervisors or designees of alerts via Reddi-Net when necessary.
14. Participates in interdepartmental committees and task forces representing the Patient Access department.
15. Completes the Midnight Census compare and makes necessary changes in applicable systems nightly.
16. Participates in daily performance improvement huddles and hospital activities using lean tools and techniques.
17. Reviews physician orders for completeness to ensure compliance during intake.

Department Specific Competencies

Education

Degree Program

Additional Information

Experience

Number of Years Experience: 1 year in healthcare revenue cycle, medical industry, or customer service.

Additional Information: N/A

Compensation Range: $23.00 - $32.46 per hour