Patient Access Representative I-3

musc; United States; Vor Ort; USD 25.000 - 33.000; Vollzeit

Zusammenfassung

Medical University Hospital Authority (MUHA) is seeking a Patient Access Associate to verify and prepare patient accounts for inpatient and outpatient billing and to maximize payment for hospital and clinic services.

The role involves reviewing payment methods, confirming patient/insurance information, arranging payment plans, and assisting patients with funding options while maintaining high standards of customer service.

Aufgaben

• Verifies and enters/upgrades all patient demographics and insurance information in registration systems.
• Verifies insurance coverage and coordinates benefits using Real Time Eligibility or payer portals.
• Collects copayments and ensures accurate posting and balancing of payments.
• Assists patients with payment arrangements and applies for available assistance programs.
• Ensures regulatory forms are completed and patient education materials are provided.
• Maintains up-to-date knowledge of payer requirements and internal policies to meet performance metrics.

Jobbeschreibung

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)

Job Description

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

Physical RequirementsAbility 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