Patient Access Representative I-2

musc; Summerville (SC); On-site; USD 25,000 - 36,000; Full time

Job summary

MUHA seeks a Patient Access Associate to verify patient demographics and insurance details for inpatient and outpatient billing. You will collect payments, discuss payment options, and assist patients with financial arrangements and assistance programs.

Responsibilities include confirming insurance, updating records, and coordinating with payers to maximize reimbursement while delivering high-level customer service at the point of care.

Qualifications

• Customer service experience in a healthcare setting.
• Ability to verify insurance and determine benefits.
• Experience with patient financing and payment collection.

Responsibilities

• Verify and enter patient demographics and insurance data.
• Explain payment options and assist with payment plans.
• Verify coverage and pre-authorizations; coordinate with payers.
• Collect and post payments accurately; balance cash at shift end.
• Support patients with billing inquiries and resolve issues.

Skills

Customer service

Insurance verification

Cash handling

Billing inquiries

Empathy

Tools

Registration system

Real Time Eligibility

Job description

Job Description Summary

Entity: Medical University Hospital Authority (MUHA)

Worker Type: Employee

Worker Sub-Type: Regular

Cost Center: CC002306 CHSCorp OH - Hospital Admissions

Pay Rate Type: Hourly

Pay Grade: Health-21

Scheduled Weekly Hours: 36

Work Shift:

Job Description

POSITION DESCRIPTION

POSITION PURPOSE

Reporting to the Patient Access Manager, the Patient Access Associate exhibits a high level of customer service while verifying and preparing all patient accounts for inpatient and outpatient billing in order to maximize payment for Hospital and Clinic services. Reviews and verifies all payment methods available (insurance, self-pay, agency), verifies patient/insurance information, works with patients to set up payment arrangements and to arrange/apply for assistance programs, assists in collecting copayments and deductibles, and problem solves basic billing inquiries.

Primary Duties and Responsibilities

OBTAINS/CONFIRMS AND ENTERS/UPDATES DEMOGRAPHIC AND INSURANCE INFORMATION FOR ALL PATIENTS

• Consistently confirms, enters, and/or updates all required demographic data on patient and guarantor in registration system(s) on a daily basis to achieve maximum payment.
• Secures and/or explains copies of insurance card(s), forms of ID, and signature(s) on all required forms and scans them into the appropriate imaging documentation system.
• Consistently completes the Medicare Secondary Payer (MSP) questionnaire, if applicable.
• Discusses Advanced Directives with patients and obtains a copy for the patient's record, if available.
• Reviews all other regulatory forms and information with the patient, such as Notice of Privacy Practice and Billing information.
• Verifies insurance using Real Time Eligibility, Payer Website, or phone number to determine coordination of benefits and obtains authorization and/or referrals as required.
• Follows procedures to accurately identify a patient and apply the patient identification bracelet, if applicable.
• Registers patients during downtime following downtime procedures and enters data into registration system immediately upon system availability.
• Performs Service Recovery as needed at the point of service with patients and visitors.

VERIFIES INSURANCE COVERAGE, SCREENS PATIENT FOR POTENTIAL FUNDING SOURCES, AND SETS EXPECTATIONS FOR REIMBURSEMENT OF SERVICES

• Verifies financial information to determine insurance coordination of benefits, pre-certification/prior-authorization requirements by contacting the insurance company or through other verifying technology.
• Informs self-pay patients of prepayment requirements or screens for funding sources
• Prepares estimate of procedures, calculates advance payment requirements, informs patient of acceptable payment arrangements on previous and current balances
• Refers potentially eligible patients to contract eligibility vendor(s) to pursue funding reimbursement
• Coordinates with clinical areas to establish patient financial expectations and assist in the resolution of revenue cycle issues
• Maintains up to date knowledge, requirements, and skills to perform daily duties and meet key performance metrics for the facility, unit, and payers. For example, employee must read all e‑mails/newsletters and attend required training sessions.

COLLECTS, POSTS, AND RECONCILES ALL PAYMENTS FROM PATIENTS

• Consistently collects patient payments and provides receipt accurately completing all required fields.
• Calls patient prior to date of service to inform them of their expected financial liability. Will educate patient on their respective benefits and accept payment over the phone is patient agrees.
• Coordinates with appropriate providers when payment is unable to be collected from the patient. If necessary, secure a waiver for services.
• Accurately posts all payments on system.
• Accurately reconciles receipts with cash collected and completes required balancing forms at the end of their shift.

PERFORMS OTHER POSITION APPROPRIATE DUTIES AS REQUIRED IN A COMPETENT, PROFESSIONAL, AND COURTEOUS MANNER

• Ability to perform job functions while standing. (Frequent)
• Ability to perform job functions while sitting. (Frequent)

Ability to perform job functions while walking. (Frequent)

• Ability to climb stairs. (Infrequent)
• Ability to work indoors. (Continuous)
• Ability to work from elevated areas. (Frequent)
• Ability to work in confined/cramped spaces. (Infrequent)
• Ability to perform job functions from kneeling positions. (Infrequent)
• Ability to bend at the waist. (Frequent)
• Ability to squat and perform job functions. (Infrequent)
• Ability to perform repetitive motions with hands/wrists/elbows and shoulders. (Frequent)
• Ability to reach in all directions. (Frequent)
• Possess good finger dexterity. (Continuous)
• Ability to fully use both legs. (Continuous)
• Ability to fully use both hands/arms. (Continuous)
• Ability to lift and carry 15 lbs. unassisted. (Infrequent)
• Ability to lift/lower objects 15 lbs. from/to floor from/to 36 inches unassisted. (Infrequent)
• Ability