Patient Access Representative (Part-time | 8 hours per week)

Children's National Hospital; Washington (District of Columbia); On-site; USD 45,000 - 55,000; Full time

Job summary

Children's National Hospital seeks a Patient Access Representative to provide essential patient services and administrative support. This role involves scheduling appointments, verifying insurance eligibility, and ensuring high-quality customer service within a healthcare environment. The ideal candidate possesses a strong background in administrative processes and customer interaction with required experience.

Qualifications

• 2 years related experience required.
• Broad knowledge of administrative processes necessary.
• Completion of Patient Access training curriculum and competency assessments is required.

Responsibilities

• Provide patient services and administrative support in ancillary operations.
• Collect and verify all demographic information to ensure accuracy.
• Schedule patients for ancillary appointments.

Skills

Customer service skills

Administrative processes

Computer knowledge

Microsoft Office

Typing speed of 35 words per minute

Education

High School Diploma or GED

Job description

This position reports to the Patient Access Supervisor or Manager. Provide patient services and administrative support in ancillary operations. Interact with parents, patients, physicians, and other staff under moderate supervision in a courteous manner. Provide assistance to other employees within their department as well as other departments. Collect and verify all demographic information to ensure accuracy. May provide required notification of scheduled and unscheduled services according to insurance provider requirements. May be responsible for scheduling patients for ancillary appointments. Position may be required to float to ancillary patient access areas for coverage (ED, RAD, LAB, AMSAC, etc.). The next step in the career ladder is Senior Patient Access Rep.

Minimum Education
High School Diploma or GED (Required)

Minimum Work Experience
2 years related experience (Required)

Required Skills/Knowledge
Broad knowledge of administrative processes, customer service skills. Computer knowledge necessary. Microsoft Office experience preferred (Word & Excel). Complete Patient Access training curriculum and pass all competency assessments. The ability to type a minimum of 35 words per minute required.

Functional Accountabilities

Patient Services

• Demonstrate accuracy in scheduling patients using the applicable scheduling system for the department. Verify applicable charge codes correspond with diagnostic codes. Enter information into billing/registration system.

• Complete computer-aided, online registration screen with parent/guardian via telephone or in person in a professional & courteous manner.

• Collect accurate demographic and insurance information. Update systems as needed in accordance with department standards for registration accuracy. Complete bedside registration for ED patients.

• Reschedule appointments for patients who did not show or for the ancillary services cancellations by providers/technologists. Schedule follow-up appointments at check-out if applicable.

• Greet patients and parents courteously. Arrive patient in the appropriate system based on department policy.

• Obtain required consents for the department & ensure distribution of compliance-related materials (i.e., HIPAA Privacy Notice, Patient Rights). Obtain a copy of insurance card and photo ID to be stored in medical records (copy or scan activity required). Ensure applicable insurance company and CNMC HIM department receive copies of appropriate forms/documentation. Complete all documentation in accordance with department policy and procedure.

• Respond to patient portal work lists (appointment requests, fax queues, email requests, etc.). May include messaging center work lists in the future.

Information Verification

• Verify insurance eligibility using applicable eligibility system. Ensure managed care carve-outs (lab and radiology carve-outs) are adhered to.

• Advise leadership of any authorization issues at check-in. Identify surgeries/diagnostic testing without authorizations. Contact provider’s office or scheduling coordinator to address issues timely without delaying patient care.

• Notify parents of the need for completed insurance referral forms or pre-authorization prior to scheduled/unscheduled appointments.

• Discuss co-payment, deposits, payment in full, or past-due balance collections with parents professionally & courteously.

• Counsel parents or refer to Financial Information Center (FIC) for establishing payment schedules or methods.

• Verify insurance information is complete prior to procedures and collect and verify pre-authorization/referral information. Goal: obtain authorizations 5 days in advance of service.

• Utilize all systems where patient information may be stored (EPRS, SCI, Cerner, IDX, McKesson, etc.) to verify system synchronization.

Cash Collection

• Collect and record co-payments, deposits, and payments in full. Provide payer with receipts. Responsible for helping department meet 85% of the collection target.

• Maintain departmental requirements regarding cash controls and collections.

Billing Preparation

• Ensure all applicable orders/scripts/referrals are obtained prior to services being rendered for ancillary services.

• Clear all walk-in appointments and ensure scheduled/unscheduled appointments are linked to the scheduling system.

• Ensure daily quality review of all registration processed in real-time.

Office Support

• Answer telephone calls and address caller needs appropriately. Meet department standards relative to ACD policies if applicable. Manage voice mail messages within the same business day.

• Distribute mail. May handle returned mail as needed.

• All staff are responsible for information distributed via e-mail. Staff should check work email a minimum of 3 times daily and respond within 24 hours (or next business day).

• Maintain office files and supplies at P AR levels.

• Maintain a clean reception area and workspace.

• Provide other support as needed.

Organizational Accountabilities

Staff

• Anticipate and respond to customer needs; follow up until needs are met.

Teamwork/Communication

• Demonstrate collaborative and respectful behavior.

• Partner with team members to achieve goals.

• Be receptive to others’ ideas and opinions.

Performance Improvement/Problem-solving

• Contribute to a positive work environment.

• Demonstrate flexibility and willingness to change.

• Identify opportunities for process improvement.

• Make appropriate decisions using sound judgment.

Cost Management/Financial Responsibility

• Use resources efficiently.

• Seek less costly ways of doing things.

Safety

• Speak up about unsafe behavior or performance.

• Continuously verify information needed for decisions or documentation.

• Stop and resolve uncertainties.

• Communicate clearly and timely.

• Promote safety for patients, families, visitors, and co-workers.

• Pay attention to details, practicing Stop, Think, Act, and Review to self-check behavior and performance.