Patient Access Rep I
Company: Advocate Health
Location: Park Ridge
Posted on: April 25, 2024
Job Description:
Major Responsibilities:
- Responsible for performing all job duties in a way that
conforms to our customer service philosopy and consistent with our
"AIDET" standards
- 1)Greet and Acknowledge all patients and family members in a
welcoming and prompt manner.
- 2)Introduce the patient to our services, what they can expect
while under our care. Utlize appropriate etiquette in all
communications.
- 3)Provide the patient with information on the likely time spent
in the service area (duration) including time in registration and
time in clinical service.
- 4)Explain the nature of our work, why we ask for demographic,
socio-economic, and financial information. Explain how we safeguard
their information and use it to provide better care for them.
- 5)Hand-patients off to the next area with a clear "thank
you."
- When creating new registrations for walk-in patients,
responsible for the identifying insurance coverage, the benefits
available, patient out-of-pocket expenses, and collecting
co-insurance and co-payments.
- 4)Collecting appropriate out of pocket expenses in accordance
with policy.
- 1)Uses electronic systems to confirm coverage while patient is
present and discussing the findings with the patient. Follow
established department policies to resolve issues related to
patient's eligiblity for coverage or issues in in-network status
for the patient using Advocate's network.
- 2)When working uninsured patients, screen for urgent status
cases and follow charity processedure. Refer as appropriate for
additional financial counseling. Engage leaders to resolve
questions on urgent versus non-urgent/elective care.
- 3)When assisting walk-in pateints, screen orders for compliance
with policy. Work with physicians, Care Coordinators, and clinical
department leaders to communicate and resolve issues related to
order quality and acceptable standards.
- Responsible for security authorization and precertification of
inpatient and outpatient services.
- 5)Notify Financial Counseling, physicians, Care Coordinators,
and Utlilization Management on cases were patients are found to be
uninsured, or where the only insurance is Third Party Liability or
Workers Compensation
- 1)Maintains knowledge of all stand-alone computer software
programs to verify eligibility.
- 6)Identify at risk balances related to Medicare co-days,
lifetime reserve days and other Medicare coverage limits and
communicate to Financial Counseling, UM and physicians
- 7)Identify at risk balances relate to Medicaid eligibility
rules and communicate to Financial Counseling, UM and
physicians
- 8)Initiates communication to patient when authorization is not
obtained and explain the potenital financial impact and the patient
responsiblity for unauthorized services
- 9)Accurately collects and analyzes clinical data in support of
prior authorization, and precertification as required by payor
guidelines
- 10)Acquires and maintains current knowledge of all insurance
requirements as it relates to patient/hospital responsibility and
hospital billing.
- 2)Stays current of all Federal and State regulations regarding
billing.
- 3)Ensures completion of all established policies and procedures
for identification and notification of the Primary Care Physician
in the case of HMO coverage plans.
- 4)Informs Financial counseling, physicians, Care Coordinators
and Utilization Management of out of network or noncovered service
limitations of managed care/commerical insurance where benefits are
at risk
- Responsible the pre-registration and registration accuracy.
- 6)Maintains knowledge of State & Federal regulations governing
Medicare, Medicaid and Mental Health registrations.
- 1)Ensure accurate entry of patient demographic, insurance
information in the ADT system with special attention to carrier
code assignment, complete benefit, eligiblity record and
authorization data
- 2)Pre-registers and registers patients using established
procedures for computer entry for all ancillary and nursing units,
keeping current with their specialized needs and preparing
necessary documents/records when necessary.
- 3)During the pre-registration or registration encounter,
provide detailed education to the patient the contents of documents
and forms requiring patient signature.
- 4)Manage incoming and outgoing calls in order to complete
pre-registrations with patients
- 5)Generates, assembles and processes all required documents for
completion of each registration.
- Participates in departmental team building activities and
inservices and other miscellaneous duties as assigned by leader.
- 1)Contributes to the quality initiatives and mission by
participating in team projects.
- 2)Attends all required departmental inservices to stay current
of all job changes and responsibilities.
- 3)Assist leader in special assignments as may be needed to
forfill the mission of the department and the organizaiton.
Education/Experience Required:
- High School Diploma with 2 years of experience in either
Patient Access or any of the following related experience; general
physician office support or billing office, insurance office,
hospitality, or call center (any industry) Intermediate math skills
aquired through classroom work or through work experience
Knowledge, Skills & Abilities Required:
- Typing 25 WPM Basic understanding of web-based systems,
proficiency in data entry
- N/A
Physicial Requirements and Working Conditions:
- Ability to prioritize and organize workload Sophisticated
interviewing, communicaiton and negotiation skills Independent
decision making Ability to work hours that verify based on needs of
the organization including evenings, weekends and holidays. ility
to work as a team member
Addendum: In addition to the Accountabilities and Job Activities
outlined in Sects. I. A. - I. D. of the Position Description for
Patient Access Registrar the following accountabilities and job
activities are applicable for registrars staffed at offsite imaging
centers: E. Performs additional activities that facilitate patient
flow and transition from registration to the clinical testing area
including: 1. Performs Computerized Provider Order Entry (CPOE) for
exams accurately and completely to transcribe written physician
orders. Seeks clarification from technician and physician if
needed. 2. Performs light duty cleaning of changing areas as
needed. 3. Prints patient's results CDs when required and
distributes finished exam results CD to patient while complying
with application HIPAA considerations. 4. Escorts patients to
changing areas as needed.
This job description indicates the general nature and level of work
expected of the incumbent. It is not designed to cover or contain a
comprehensive listing of activities, duties or responsibilities
required of the incumbent. Incumbent may be required to perform
other related duties.
Keywords: Advocate Health, Oak Park , Patient Access Rep I, Other , Park Ridge, Illinois
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