Patient Access Representative, Resource Pool

Responsible for performing scheduling, pre-certification, benefit verification and pre-certification, Requires fast response to customer needs, independent judgement, ingenuity and initiative in utilization of computers and other equipment. Works with staff and understand appropriate scheduling processes and how processes affect ancillary departments. Conducts patient and guarantor interviews for inpatient, outpatient and emergency care registration, Explains hospital policies and financial responsibilities and obtains all required signatures. Ensures that all demographic and financial data is obtained and entered in the EPIC system in an accurate and timely manner. Ensures that pre-certification and/or authorization is obtained to comply with insurance company policies. Determines estimated patient financial responsibility through verified insurance benefits, co-pays and deductibles and calculates estimated self-pay portions to be collected at time of registration. Controls the main line of communication with physicians, nursing, clinical staff, non-clinical staff and Patient Access Department to ensure appropriate patient scheduling for proper entry into and through the health care system. Performs all other duties as assigned by the management team.

Special Qualifications

High School Diploma or equivalent
General knowledge and experience in the healthcare industry is preferred
Strong Customer service experience
Ability to communicate effectively both orally and in writing
Working knowledge of medical terminology ICD-10 and CPT Coding
Ability to build productive internal and external working relationships
Basic analytical skills
Strong organizational skills and attention to detail
Ability to handle challenging customers in a professional manner