Patient Access Representative

Touchette Regional Hospital; East St. Louis (IL); On-site; USD 35,000 - 48,000; Full time

Job summary

Touchette Regional Hospital in East St. Louis, IL is seeking a patient registration specialist to handle admissions, emergency and outpatient registrations.

The role includes order entry, verifying insurance eligibility, checking Medical Necessity, and collecting co-pays and deductibles with accuracy and sensitivity. Responsibilities involve coordinating with physicians, departments, and patients, ensuring privacy, and acting as a financial advocate for self-pay patients while maintaining high

Qualifications

• Excellent customer service skills
• Strong attention to detail and data accuracy
• Ability to protect patient privacy and confidentiality

Responsibilities

• Explain Medicare responsibilities to patients and assist with interpreter needs
• Coordinate data flow between physicians, office staff, nursing floors, and departments while maintaining patient confidentiality
• Assist in verification and pre-certification of insurances and act as a financial advocate for self-pay patients
• Greet and direct patients, visitors, and sales staff with courtesy
• Register patients by verifying records and updating computer systems
• Enter confidential health and financial information into the system with high accuracy
• Process payments, apply payments and adjustments, and reconcile daily cash reports
• Verify Medicare Medical Necessity and prepare ABN when needed with information sheets
• Complete the Medicare Secondary Payer Questionnaire accurately and adjust payment sequences as necessary
• Verify insurance eligibility for each patient and update records accordingly
• Document discrepancies in patient records that affect insurance
• Confirm charity eligibility for self-pay patients per hospital criteria and communicate outcomes
• Perform other duties as assigned

Job description

Job Summary

To perform all registration responsibilities at Touchette Regional Hospital for patients seeking admission, emergency treatment, and/or outpatient services. This includes but is not limited to: order entry tasks, checking for Medical Necessity, and verifying insurance eligibility. This position also requires verifying charity eligibility, collecting insurance copayments, deductibles, and all other responsibilities associated with processing a patient visit.

Functions And Duties

• Exhibits excellent customer service skills during any function of the registration process, including understanding when an interpreter is needed, providing patients with additional information regarding Medicare responsibilities, or more information regarding medical directives.
• Assist in the flow of data between physicians, physician office staff, nursing floors, ancillary departments, emergency department, patient business services, insurance companies and patients while insuring patient confidentiality is not breached.
• Assists patients with verification and pre-certification of insurances and acts a financial advocate for self-pay patients.
• Treat patients and coworkers with courtesy and discretion. Greets and directs patients, salespeople, and visitors.
• Registers patients by verifying that patient's record is up to date and accurate. Makes appropriate changes in computer system.
• Enters confidential personal health information and financial information into computerized system with a high rate of accuracy.
• Collects payment from patients, applies payments and adjustments to patient accounts in the computer system, and reconciles daily cash reports.
• Verify that all tests pass Medicare Medical Necessity. In the event a test fails, ensures that the Advanced Beneficiary Notice (ABN) is created and presented to the patient along with an information sheet describing to the patient their options.
• Ensure that the Medicare Secondary Payer Questionnaire is accurately completed with the responses provided by the patient and adjust Medicare payment sequence when necessary.
• Verify insurance eligibility for each patient using system program, and update the record to reflect any updated information or changes necessary.
• Document any and all discrepancies in the patient record that affects insurance.
• Confirm charity eligibility for all self-pay patients that meet hospital criteria and discuss the outcome with the patients.
• Performs all other duties as assigned.