Seamless Access Representative

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

Job summary

An established industry player in healthcare is seeking a dedicated Patient Access Specialist to enhance patient experiences. This role involves registering patients, gathering essential demographic and insurance information, and ensuring compliance with healthcare regulations. The ideal candidate will possess strong communication and customer service skills, with a background in healthcare or insurance. Join a forward-thinking organization committed to providing compassionate care and innovative solutions in a dynamic work environment.

Qualifications

• 3+ years of customer service experience in healthcare or insurance.
• Proficient in Microsoft Office and EHR applications.

Responsibilities

• Register patients and gather accurate demographic and insurance information.
• Verify insurance coverage and collect out-of-pocket liabilities.

Skills

Customer Service

Communication Skills

Insurance Verification

Microsoft Office

Medical Terminology

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. Entering orders and confirming medical necessity for outpatient visits, if appropriate. Interviewing 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

Workday Day (United States of America)

Worker Sub Type

Regular

Primary Location Address

925 Chestnut Street, Philadelphia, Pennsylvania, United States of America

Jefferson, located in the greater Philadelphia region, Lehigh Valley, Northeastern Pennsylvania, and southern New Jersey, is reimagining health care and higher education to create unparalleled value. With over 65,000 staff, Jefferson provides high-quality, compassionate clinical care, advances community health, prepares future professionals, and conducts innovative research. Founded in 1824, Jefferson comprises 10 colleges and three schools, offering over 200 undergraduate and graduate programs to more than 8,300 students. Jefferson Health, ranked among the top 15 not-for-profit health care systems nationally, operates 32 hospitals and over 700 outpatient and urgent care locations, serving millions annually. Jefferson Health Plans, a not-for-profit organization, has provided broad health coverage options in Pennsylvania and New Jersey for over 35 years.

Jefferson is committed to equal opportunity employment and education, regardless of age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military or veteran status, disability, or any other protected class.