About

Job Summary

The Patient Access Representative performs

• * Registrations of inpatient/outpatient visits including, but not limited to, patient interviews, signing of forms, scanning of documents and routing of patients
• * Scheduling of Inpatient/Outpatient visits for a variety of departments
• * Verification of insurance eligibility and benefits as well as authorization for procedures as applicable
• * Other duties as assigned or required by the Patient Access Manager, Director of Patient Access or their designee.    

Job Relationships

• 1. Directly responsible to the Patient Access Manager, Director of Patient Access or their designee
• 2. Works closely with hospital district leadership and departments as well as internal and external customers

Occupational Hazards

• Works in the general hospital setting. May be exposed to blood, body fluids, or tissues as well as patients in varying stages of infectious states.  

Samples of Duties

• The information listed below is meant to serve as samples of job duties and responsibilities for positions in this classification. This list is neither inclusive nor exclusive, but indicative of several types of duties performed. 

• * Receives and interviews incoming patients or relatives to obtain or update pertinent demographic, guarantor, emergency contact, Primary Care Physician, and insurance information including Obtains financial information and insurance signatures for department patients. Discuss patient financial responsibility. Obtain/Scan insurance card(s) and valid photo ID
• * Calls Patients for appointment confirmation and pre-registers all upcoming outpatient appointments and prepares account for the visit. Verifies patient demographics, emergency contact, patient’s ID and most current Insurance cards are scanned including verifying patient’s Eligibility of insurance, including Work Comp information
• * Responsible for prompt, courteous reception and processing of all patients presenting themselves for treatment or referrals.
• * Schedules, registers and checks in patient visits according to department standards to allow for smooth patient flow and decreased waiting time. Preregister patient visits as time allows
• * Scans pertinent documents into the EMR including but not limited to the photo ID, insurance cards, authorization documents, physician orders and the COA, Race Identification Form.
• * Collects payments for outpatient services including all cash patients, giving discounts when appropriate; and collects ALL co-payments before the patient is seen for patient services and balances cash drawer at end of shift.
• * Collects additional data for Medicare, Medicade/MediCal, and the Department of Health Services as required
• * Inputs all information into the HIS, obtaining necessary signatures required for the patient on the initial visit such as consent for treatment, and insurance forms
• * Runs the eligibility check for all Medicaid coverage at the time of the pre-reg and verifies/updates the accuracy of the insurance plan code. Reruns the eligibility check on the date of service prior to the patient’s arrival to verify the coverage has not changed, scans POS into encounter.
• * Verifies that accident information is entered as required for all visits pertaining to an accident/injury.  Collects other accident information (other than Worker’s “Compensation claims) when applicable.
• * Obtain Workers’ Compensation claims information and all information needed to complete a Dr’s First Report. Including claim number if available, insuring Work Comp information has been entered correctly
• * Answers multi-line phone in a courteous manner, takes messages for providers and other staff in an accurate manner
• * Admits the visit insuring the COA has been signed at each visit and ensure signing of NOPP for new patients. Provides patients with copies of signed documents.  Ensures that patients paperwork is accurate and completed, including re-signing consent and insurance forms yearly
• * Notifies the receiving department of the patients arrival and routes all pertinent paperwork, armbands or labels as required by the receiving department
• * Maintain flexibility in shift schedule which may vary or change to meet the needs of the hospital
• * Adheres to the policies and procedures and guideline of the hospital and department, including representing the hospital in a professional manner
• * Reports unusual or abnormal activity to the appropriate person or department
• * Ensure confidentiality of patient information
• * If stationed in Diagnostic Imaging, may assist in scheduling modalities with knowledge and understanding of proper prep instructions and must learn to navigate Imaging Department systems, will be able to schedule labs, find off site orders.  Pre-register verify insurance eligibility and authorization as necessary.
• * If stationed in the Rehabilitation Office, may assist in scheduling appointments with knowledge of department services and systems, and will prepare, update, and fill out all department and patient forms.   Pre-register verify insurance eligibility and authorization as necessary.
• * If stationed in Central Registration, will be able to schedule labs, find off site orders, pre-register, check in and verify all out patient nursing services, dietary and perinatal accounts. Pre-register verify insurance eligibility and authorization as necessary.
• * May assist in training new staff on the processes, workflows and functions of this position
• * May cross-train to other registration areas in the inpatient/outpatient
• * May perform other duties within Patient Access as requested, including those in other Patient Access areas which could be outside the normally scheduled shift of this position. 
• * Other duties as assigned.

Knowledge, Skills and Abilities

Knowledge of

• * Modern office equipment and computer programs;
• * NIHD Patient Access department practices and procedures;
• * Conflict resolution practices;
• * The Mission, Vision, and Values of Northern Inyo Healthcare District; 
• * NIHD policies and procedures, including Compliance Program, Code of Conduct, and Confidentiality standards;
• * NIHD safety policies and procedures, including the Rainbow Chart, Employee Health, and Infection Prevention standards;

Skills/Abilities to

• * Perform work tasks under variable pressures;
• * Work in a multi-task environment and accept interruptions while performing duties;
• * Problem solve and analyze in the work environment; 
• * Communicate regularly and effectively, both verbally and in writing with department leadership, NIHD staff and the public;
• * Develop flexible and efficient time management and prioritization;
• * Establish and maintain professional working relationships with NIHD staff at all levels as well as the public;
• * Develop and maintain a high degree of maturity, integrity, and good judgement.

Minimum Qualifications

• * High School diploma or equivalency.

• Preferred: 

• * Prior experience with Cerner or other EHR systems
• * High volume customer service experience
• * Experience with multiline phones
• * Receptionist/clerical experience
• * Bilingual (Spanish).

• **After minimum of 6 months, PA Rep I may promote to PA Rep II, based on knowledge, competencies. Competencies must be validated.

• Monday-Friday