Patient Access Representative - Full-Time - APN AVALA Ortho - RO52

Avala; Covington (VA); On-site; USD 32,000 - 46,000; Full time

Job summary

Avala in Covington, VA seeks a Patient Access Representative to collect patient demographics and insurance details during interviews, both in person and by phone. You will complete registrations, obtain signatures for treatment authorization, ABN, and MSP questionnaires, and scan documents into the CPSI system.

The role requires friendly, accurate data entry, the ability to explain forms to patients, and timely collection of balances due.

Qualifications

• Must have high school diploma and relevant regulatory awareness.
• Minimum 2 years of patient registration or front-desk experience.
• Strong communication skills in English and basic computer literacy.

Responsibilities

• Register patients and collect accurate demographics and insurance information.
• Explain forms (Authorization for Treatment, ABN, MSP) and obtain signatures.
• Pre-register patients, verify information, and inform about estimated balances due.
• Handle high call volumes and route calls to the appropriate department.
• Balance daily receipts and ensure compliant documentation.

Skills

English communication

Computer literacy

Education

High school diploma

Job description

Summary

Under the supervision of the Director of Operations, the Patient Access Representative is responsible for obtaining accurate patient demographics and insurance information during the patient interview process; the process includes in-person, and phone interviews, corrects information as needed. Processes the registration including obtaining the patients signature on the Authorization for Treatment, Advanced Beneficiary Notice (ABN) and completing the Medicare Secondary Payer (MSP) questionnaire. Scans all necessary documentation into CPSI. Collects co-payments, estimated co-insurance and deductibles, which includes phone calls to patients to discuss financial responsibility prior to service as well as collecting at time of service. Answers incoming phone calls and assist caller as needed. And any other duties assigned by the Director of Operations.

Essential Duties and Responsibilities

• Registration Front Desk
• Able to handle heavy phone volumes, ensures that callers are transferred to the appropriate department and/or person. Answers calls in a timely manner; identifies department and self when answering the telephone. Able to handle all codes and stat calls proficiently.
• Verifies that patient demographic information is accurate and ensures that insurance cards, consents and other admission documents are complete and in order.
• Ability to explain required forms to the patient in detail (i.e.: Authorization for Treatment, Advanced Beneficiary Notice (ABN), Medicare Secondary Payer (MSP) questionnaire). Obtains required signatures as needed.
• As part of the pre-registration process, contacts patient to verify demographic information, insurance information, and MSP questionnaire.
• Informs patients of estimated balance due and collects monies due at time of service.
• Assist with chart preparation, ensuring that all packets are accurate; forwards charts to ENDO and/or other nursing personnel at least 3 days in advance of scheduled procedure.
• Demonstrates knowledge of all features and functions of the CPSI Patient Accounting areas.
• Notifies appropriate staff regarding any issues or concerns in a timely manner.
• Balances daily receipts list to cash, checks, and credit card payments received at the end of each day.

Other Duties

• Functions as back up to concierge.
• Other duties as assigned.

Action Orientation

Targets and achieves results, overcomes obstacles, accepts responsibility, establishes standards and responsibilities, creates a results-oriented environment, and follows through on actions.

Communications

Communicates well both verbally and in writing. Effectively conveys and shares information and ideas with others. Listens carefully and understands various viewpoints. Presents ideas clearly and concisely and understands relevant detail in presented information.

Creativity/Innovation

Generates novel ideas and develops or improves existing and new systems that challenge the status quo, takes risks, and encourages innovation.

Critical Judgment

Possesses the ability to define issues and focus on achieving workable solutions. Consistently does the right thing by performing with reliability.

Customer Orientation

Listens to customers, builds customer confidence, increases customer satisfaction, ensures commitments are met, sets appropriate customer expectations, and responds to customer needs.

Interpersonal Skills

Effectively and productively engages with others and establishes trust, credibility, and confidence with others.

Leadership

Motivates, empowers, inspires, collaborates with, and encourages others. Builds consensus when appropriate. Focuses team members on common goals.

Teamwork

Knows when and how to attract, develop, reward, and utilize teams to optimize results. Acts to build trust, inspire enthusiasm, encourage others, and help resolve conflicts and develop consensus in creating high-performance teams.

Professional Requirements

• Meets dress code standards and adheres to policies.
• Completes annual education requirements.
• Maintains regulatory requirements.
• Maintains patient confidentiality at all times.
• Reports to work on time and as scheduled, completes work within designated time.
• Wears identification while on duty, uses computerized punch time system correctly.
• Completes in-services and returns in a timely fashion.
• Attends annual review and department in-services, as scheduled.
• Attends staff meetings annually, reads and returns all monthly staff meeting minutes.
• Represents the organization in a positive and professional manner.
• Actively participates in performance improvement and continuous quality improvement (CQI) activities.
• Complies with all organizational policies regarding ethical business practices.
• Communicates the mission, ethics and goals of the hospital, as well as the focus statement of the department.
• Promotes professional growth of subordinates by sharing knowledge and/or directing them to sources if information appropriate to given situation. Utilizes journals, books, etc. to learn and/or improve new techniques and equipment.
• Assists other staff members in performing any duty that enhances the delivery of patient care.

Regulatory Requirements

• High school diploma.
• Two (2) or more years’ experience.

Skills

• Ability to communicate effectively in English, both verbally and in writing.
• Basic computer knowledge.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. This position is very active and requires repetitive motions, standing, walking, bending, kneeling and stooping all day. The employee must frequently lift or move items weighing up to 20 pounds.