Patient Access Representative - Pediatrics Edenton

ECU Health; Edenton (NC); On-site; USD 32,000 - 45,000; Full time

Job summary

ECU Health Medical Center is seeking a patient access representative to register patients, interpret insurance benefits, and support billing and regulatory compliance in a high-volume hospital setting.

Responsibilities include collecting demographics and insurance details, explaining forms and clinic policies, preparing electronic financial folders, and ensuring accuracy of registrations and charges in the EPIC system. Excellent communication and multitasking are essential.

Qualifications

• High School diploma or GED required.
• Associate degree preferred.
• Bachelor's degree preferred.
• Minimum 2 years Customer Service in healthcare setting required.
• 1–2 years Registration and/or Billing experience preferred.

Responsibilities

• Register patients and representatives accurately and efficiently.
• Obtain demographic and insurance information for billing and compliance.
• Explain forms to meet privacy and regulatory requirements.
• Prepare electronic financial folders with billing documents.
• Enter charges and maintain EPIC workqueues (charge entry, claims) in the system.
• Greet patients professionally and direct to service areas.
• Cross-train to perform other Patient Access duties.
• Maintain daily registration activity logs and productivity reports.
• Monitor forms for signatures and completeness.

Skills

Patient Registration

Insurance Billing

Interpersonal Skills

Data Entry

Regulatory Knowledge

EPIC Software navigation

Education

High School or GED

Associate Degree: preferred

Bachelor's Degree: preferred

Tools

EPIC Software

Job description

Position Summary

Performs patient registration. Provides insurance benefits interpretation and counseling. Maintains medical terminology skills and knowledge of third party payer regulations. Performs patient and customer relations. Completes other duties as assigned.

Responsibilities

Register patients and or their representatives in a timely and efficient manner. Obtain demographic and insurance information for billing, compliance and release of information. Requires strong interpersonal skills and ability to interview patients in stressful situations. Patient registrations are performed in a high volume, fast-paced, dynamic environment.

Interpret and explain various forms to meet privacy and regulatory requirement. Obtain the appropriate signatures on all require documents.

Inform patients of clinic policies such as filing of insurance, consent to treatment, and other regulatory requirements.

Prepare electronic financial folders to include all information pertinent to billing i.e. pre-certifications documents, benefits information, insurance card copies and signed registration documents.

Operate office machines; correct minor equipment failures of office machines and contact vendors when necessary to fix major equipment failures.

Review physician orders for coding and routing purposes.

Provide insurance benefits interpretation and counseling based on the information provided either via the electronic eligibility function or the manual process. Coverage is explained to the patient to include notification of any deductibles or co-pays. Payments are received after services are rendered. The pre-certification process is explained and information is verified with the patient and or representative.

Maintain medical terminology skills and knowledge of third party payer regulations.

Maintain skill set through daily use of appropriate medical terminology and application of regulations. Knowledge also supported by updates posted in regulatory bulletins and insurance contracts.

Monitor registrations for completeness and accuracy.

Maintain and submit daily registration activity logs.

Monitor forms for appropriate signatures and completeness.

Greet patients in a professional manner to determine service needs.

Direct patients to the appropriate service areas.

Cross train to perform other duties within Patient Access Services.

Maintain productivity reports.

Participate in special projects.

Coding and billing.

Enters charges from coded encounter forms/charge sheets into A/R system in a timely manner.

• Enter patient demographics into computer system.
• Enter appropriate charge in computer system.
• Maintains EPIC software workques (charge entry, claim edit, patient account) at reasonable levels.

Responsible for the timely and accurate entry of grant fund information into the designated database for tracking and reporting purposes.

• Coordinate with inpatient unit to obtain and enter appropriate charge in designated database.

Minimum Requirements

High School or equivalent (GED) or higher is required.

Associate Degree: preferred

Bachelors Degree: preferred

2 years Customer Service is required

1 to 2 years of Registration and/or Billing experience within a healthcare setting is preferred.

Excellent communication (both written and oral), detail orientation, organization, and multitasking skills required.

Basic computer skills

ECU Health

About ECU Health Medical Center

ECU Health Medical Center, one of four academic medical centers in North Carolina, is the 974-bed flagship hospital for ECU Health and serves as the primary teaching hospital for The Brody School of Medicine at East Carolina University. ECU Health Medical Center has achieved Magnet® designation twice and provides acute and intermediate care, rehabilitation and outpatient health services to a 29-county region that is home to more than 1.4 million people.

General Statement

It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.

Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.

We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant’s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.