Patient Access Representative

Brown-University-Health-1; Providence (RI); On-site; USD 42,000 - 63,000; Full time

Job summary

Brown University Health seeks a Registration Clerk to interview and register inpatients and outpatients, collecting demographic, third-party insurance, and financial information. Data is entered into the hospital system and linked to billing processes.

Under supervision, you verify demographics, obtain referrals when required, and support financial clearance and patient advocacy to ensure accurate coverage and smooth admission.

Responsibilities

• Greets and directs patients, families and visitors in a prompt and courteous manner.
• Interviews patients or their representatives to obtain complete third-party health insurance and related personal/financial information.
• Follows up on missing data by interviewing patients, families or calling employers, nursing homes and other facilities.
• Registers all patients (Outpatient, ED, Inpatient and Observation) by entering and/or verifying demographic insurance information into the hospital information system.
• Verifies demographic and insurance information and ensures proper identification and referrals as required.
• Documents financial clearance information and coordinates with Pre-Registration and Patient Financial Advocacy as needed.

Job description

SUMMARY:

Under the general supervision of the Supervisor, and according to established policies and procedures, interviews and registers all patients (Inpatient and Observation, Emergency, and Outpatients) to obtain demographic, third party insurance and related financial information, and enters to on-line computer system. Initiates, reviews and follows-up on patient accounts to ensure proper data collection for billing. Verifies all demographic and insurance information and obtains referrals as required. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:Instill Trust and Value DifferencesPatient and Community Focus and Collaborate

RESPONSIBILITIES:

Greets and directs all patients, families and visitors in a prompt and courteous manner. Interviews patient or patient’s representative in order to obtain complete and accurate third party health insurance and related personal/financial information. Follows-up on missing data by interviewing patients, families or calling employers, nursing homes and other facilitiesCompletes registration and enters all data obtained into hospital computer system. Prepares or completes manual records as follows:Ensures patient is properly identified in system per department policy. Verifies demographic and insurance information by asking open-ended questions.Registers all patients (Outpatient, ED, Inpatient and Observation) by entering and/or verifying demographic insurance information into hospital information system. Upgrades account to an active account status. Completes documentation required on financial clearance reports as indicated by Patient Advocate or Pre-Registration Office.Utilizes on line tools and/or telephone to verify coverage, determine level of benefits, and confirm that the primary care physician (PCP) matches the PCP that is recorded in hospital system. Contacts insurance carrier or company for missing information when necessary. Notifies Pre-Registration Office if coverage changes from pre-admit/pre-registration information.Identifies primary and secondary insurer. Properly records insurance information in system. Completes lien forms upon determination that a liability exists. Enter financial notes into system.Gathers paper referrals from patients, when required by the payer. Updates SMS with the appropriate documentation. Contacts Financial Counselor/Pre-Registration Office if the insurance does not verify or if the patient does not a referral when required by the payer. Utilizes system to determine self-pay balances for all patients.Uses reference tools to determine the expected payment due at time of service. Contacts Patient Financial Advocate to estimate expected payment on complex cases. Refers patients to Patient Financial Advocates if patients cannot meet the expected payment according to defined criteria. Collects co-payments as required per financial clearance or as required by third party payor or department policy. This includes cash; check credit card payments for ambulatory