PATIENT ACCESS REPRESENTATIVE I-3

C002 Medical University Hospital Authority (MUHA); Kiawah Island (SC); On-site; USD 21,000 - 29,000; Full time

Job summary

Medical University Hospital Authority (MUHA) is seeking staff for patient access and registration duties at MUHA. The role involves collecting and updating demographic and insurance information, verifying coverage, and supporting revenue cycle activities.

Responsibilities include patient data entry, insurance verification, pre-certifications, and assisting patients with billing questions, while maintaining compliance with privacy practices and hospital procedures.

Qualifications

• Associate Degree or High School Diploma with 2 years of customer service experience.
• Patient Access Certification (preferred).
• One year relevant experience in a medical office or hospital preferred.

Responsibilities

• Enter and update patient demographic data in registration systems daily.
• Verify insurance and obtain authorization/referrals as needed.
• Discuss Advanced Directives and collect copies for records.
• Review regulatory forms and inform patients about billing and privacy.
• Collect payments and post them to the system, reconcile cash.
• Follow procedures for patient identification and service recovery.
• Register patients during downtime and during system availability.

Skills

Customer service

Insurance knowledge

Communication skills

Typing 35-40 wpm

Computer literacy

Education

Associate degree or HS diploma

Patient Access Certification (preferred)

2 years customer service experience

1 year healthcare experience

Tools

Hospital information systems

Word processing

Job description

Job Summary

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: Nights (United States of America)

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

Physical Requirements

• 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 to lift from 36 inches to overhead 15 lbs. (Infrequent)


• Ability to maintain 20/40 vision, corrected, in one eye or with both eyes. (Continuous)


• Ability to see and recognize objects close at hand or at a distance. (Continuous)


• Ability to match or discriminate between colors. (Continuous)


• (Selected Positions) Ability to determine distance/relationship between objects; depth perception. (Continuous)


• Ability to maintain hearing acuity, with correction. (Continuous)


• Ability to perform gross motor functions with frequent fine motor movements. (Continuous)


• Ability to work in a latex safe environment. (Continuous)


• *Ability to maintain tactile sensory functions. (Frequent)


• (*Selected Positions) *Ability to maintain good olfactory sensory function. (Frequent)


• (*Selected Positions) *Ability to be qualified physically for respirator use, initially and as required. (Continuous) (Selected Positions)

Knowledge, Skills, and Abilities:

• Excellent customer service skills are required


• Ability to receive and express detailed information through oral and written communications.


• Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors


• Knowledge of insurance plans and benefits


• Computer literate and able to operate in multiple applications such as Microsoft Office


• Minimum typing skills of 35-40 wpm (certified typing test results required)


• Requires eye-hand coordination and manual dexterity


• Requires the use of office equipment, such as computer terminals, telephone, and copiers


• Knowledge of medical terminology.


• Able to handle multiple tasks simultaneously.


• Ability to work weekends, Friday, Saturday, and Sunday. Must be flexible and able to work flex and staggered shifts


• Requires substantial amount of walking

Education Requirements (Essential Requirements)

• Associate Degree or High School Diploma with 2 years of customer service experience


• Patient Access Certification (preferred)


• One (1) year relevant experience in a medical office or hospital preferred

Additional Job Description

High school diploma or equivalent (GED), with 1 year of customer service experience. Ability to interpret and apply financial procedures and regulations preferred. Previous experience with hospital information systems or word processing preferred. If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

Equal Opportunity Employer

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations.

E-Verify Program

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please visit http://www.uscis.gov/e-verify/employees

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Whether you want to teach the next generation of health care leaders, innovate new business models, discover the next breakthrough or provide patient care, there's a role for you that fuels your passion and takes advantage of your skills. There are career opportunities available in academics, research, hospital medicine, physician practices and support services, from patient billing to IT. As an applicant, you can search jobs for all MUSC entities as well as search by category and location. MUSC attracts more than $250 million annually in research funding, making it the biggest magnet for biomedical, extramural research dollars of all institutions of higher learning in South Carolina. The Clinical and Translational Science Award (CTSA) Program aims to advance clinical and translational science to increase the speed at which new treatments become available to patients. MUSC Health, the clinical enterprise, operates a 750 bed medical center, which includes a nationally recognized Children’s Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), Hollings Cancer Center (one of fewer than 70 elite National Cancer Institute designated centers), a Level I Trauma Center and the Institute of Psychiatry. In addition, there are more than 100 outreach clinics, hospital/health system affiliations, and telehealth sites. U.S. News & World Report placed us among the top one percent of all American hospitals, with 11 specialties in the top 50. The MUSC Medical Center is also one of only three Magnet designated hospitals in South Carolina.