Patient Access Representative

Description

Purpose:

The primary purpose of  The Patient Access Representative contributes to the overall success of the Revenue Cycle/Finance Department by communicating effectively and candidly, achieving results through teamwork and employing action oriented problem solving. This position is responsible for securing funding information for all new and recurring patients. Verification of benefits both in batch and individual interventions, VOB, Utilization Review, and Claims issues.  

Duties:

The Patient Access Representative will efficiently assist the Revenue Cycle department with various duties regarding patients funding information both new and recurring. The employee supports Revenue Cycle Department in regards to VOB, UR, Claims collections, and Appeals as necessary. 

Physical, Emotional Demands, and Work Conditions:

• Work is sedentary and ambulant with occasional physical exertion (lifting 30 or more pounds, walking, standing, etc.) ability to support patient weight in case of emergency or disability requiring assistance. Must be able to see, stoop, sit,stand, bend, reach, and be mobile (whether natural or with accommodation).
• Quality of hearing (whether natural or with accommodation) must be acceptable. Must be able to communicate both verbally and in writing. Must be able to relate to and work with mentally and physically ill, disabled, emotionally upset, and hostile patients.
• Must be emotionally stable and exhibit the ability to display coping skills to deal with multiple situations. Risk of exposure to infections, bloodborne pathogens, and other potentially infectious materials or contagious diseases. For this reason, "Universal Precautions" must always be followed.
• The Patient Access Representative should understand, support, and comply with the established workplace violence, ADA, EEOC, and Corporate Compliance program and commit to worker safety, health, and patient safety. Subject to work schedule and shift changes.

Supervision/ competency evaluations: Supervision and competency evaluations are

provided through facility monitoring activities, direct observation, staff meetings, in-services, management meetings, individual meetings, Employee Improvement processes, reporting, interactions, strategic planning, outcomes, and annual

competency review.

Competencies:

• Responsible for all patients funding information   both new and recurring.
• Retrieves and communicates information regarding Patient  benefits both written and verbal.
• Maintains Patient care databases by entering new  information as it becomes available; verifying findings and reports.
• Contributes to the team by maintaining open   communication and supporting various departments in developing and producing Patient   required documentation or information.
• Supports Revenue Cycle Department in regards to VOB,   UR, Claims collections, and Appeals as necessary.
• Completes quality audits of Patient account data to   ensure proper Patient data.
• Travels to facilities to create financial change   processes with the care teams as requested.
• Fully understand and maintain policies regarding professional ethics, including appropriate boundaries and patient   confidentiality; monitor documents according to company and HIPAA policies.
• Meet quality expectations of accuracy, completeness,   and responsiveness to feedback.
• Write clear and concise statements summarizing Patient’s   feelings, presentation and response in clinically significant encounters.
• Model appropriate interpersonal relationships,   emotional regulation, and boundaries.
• Attend and participate in assigned and required   trainings, supervisions, and weekly meetings.
• Performs other related duties as assigned.

Requirements

Patient Administrator Requirements:

• Education:  Must hold an undergraduate degree from an accredited institution. 
• Strong Verbal and Written Communication.
• Patient services and building relationships.
• Abilities in resolving conflict, coordinating, facilitating listening, scheduling, teamwork, legal compliance, medical records.
• High quality customer service.
• Ability to multitask while meeting deadlines and high-quality productivity levels.
• Flexibility and patience while championing change to improve processes, results and culture.
• Preferred candidates should have sound understanding of mental illness, co-occurring disorders.
• Proficient computer skills and ability use various software programs.
• Have a valid driver’s license in good standing and auto insurance.
• Successfully complete drug screen and comprehensive background check. 

Special Requirements:

Knowledge of applicable State Code of Regulations and 42 Code of Federal Regulations (CFR) Part 2. Compliance with accepted

professional standards and practices; Ongoing adherence to the NAADAC Code of Ethics and any other applicable Codes of Ethics for their respective profession.

Continuing Education & Professional Licensing/Certification Requirements: The employee is expected to participate in appropriate continuing education as requested and required by their immediate supervisor. In addition, the employee is expected to accept personal responsibility for other educational activities to enhance job-related skills and abilities. The employee must attend mandatory educational programs and maintain current professional certifications as delineated above in their state, in good standing.

While this job description is intended to reflect the job requirements, management reserves the right to add or remove duties from jobs when circumstances (e.g., emergencies, changes in workload, rush jobs, or technological developments) dictate. Furthermore, they do not establish an employment contract and are subject to change at the employer’s discretion.