Patient Access Representative (Relief, 3pm-12am EOW) - Center City Admissions

Thomas Jefferson University & Jefferson Health; Philadelphia (Philadelphia County); On-site; USD 35,000 - 55,000; Full time

Job summary

An established industry player is seeking a dedicated individual to enhance patient experiences through effective communication and customer service. This role involves gathering accurate patient information, verifying insurance coverage, and ensuring compliance with healthcare regulations. With a focus on teamwork and performance metrics, you will rotate through various service areas, making a significant impact on patient access and satisfaction. If you have a passion for helping others and possess strong organizational skills, this opportunity is perfect for you.

Qualifications

• 3+ years of customer service experience in healthcare settings.
• Proficient in insurance verification and medical terminology.

Responsibilities

• Gathers and verifies patient demographic and insurance information.
• Ensures compliance with regulatory requirements and performance metrics.

Skills

Customer Service

Communication Skills

Insurance Verification

Microsoft Office

Medical Terminology

EHR Applications (EPIC, Cerner)

Education

High School Diploma or GED

Associates Degree in Healthcare or Business Administration

Tools

EPIC

Cerner

Job description

Job Details

Provides a positive patient experience to patients and families. Demonstrates strong communication and customer service skills while registering patients. Accurately searches and selects the correct patient. Gathers complete and accurate demographic and insurance information from patients and families. Identifies uninsured patients for referral to Medical Assistance/Charity Care evaluation. Retrieves orders, confirms medical necessity, and answers phones for outpatient visits. Gathers worker's comp or auto insurance information from accident patients, collects patient out-of-pocket liability/copays, verifies insurance, and confirms referrals and authorizations are on file, if required.

Job Description

Essential Functions:

1. Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
2. Gathers accurate demographic information to identify Jefferson patients who have an existing medical record number or new Jefferson patients who need a medical record number assigned.
3. Requests photo ID and insurance cards, scanning copies.
4. Records complete and accurate demographic and insurance information. Enters orders and confirms medical necessity for outpatient visits, if appropriate. Interviews patients to accurately complete the Medicare Secondary Payer (MSPQ) questionnaire for all Medicare patients.
5. Uses RTE (Real Time Eligibility), Phreesia or payer websites to verify patients' insurance coverage and benefits, including patient's out-of-pocket liability. Ensures proper referral and authorizations are on file as needed.
6. Completes all activities with adherence to departmental and institutional protocols.
7. Assures regulatory and compliance requirements are met.
8. Achieves individual and team performance metrics.
9. Communicates and collects out-of-pocket liability from patients at the time of service.
10. Rotates assignment to all points of service areas within Patient Access (Outpatient Registration and Emergency Department).

Minimum Education and Experience Requirements:

Education: Required High School Diploma or GED, Associates degree in healthcare or business administration preferred.

Experience:

• Outpatient/Admissions: Minimum 3 years of customer service experience. Previous experience working in insurance, physicians/medical office or hospital registration preferred.
• Emergency Department: Minimum 3 years of experience in hospital, physician practice, or other related healthcare environment customer service required. Prior registration experience in Emergency Dept. preferred.

Competencies (Knowledge, Skills, and Abilities Required):

• Proficient with computer and Microsoft Office skills and familiar with healthcare EHR applications i.e. EPIC, Cerner.
• Knowledge of medical terminology, third-party insurance coverage including managed care plans.
• Strong verbal and written communication and customer service skills.

Work Shift

Rotating (United States of America)

Worker Sub Type

Regular

Primary Location Address

111 S 11th Street, Philadelphia, Pennsylvania, United States of America

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.