Patient Access Representative

Summary:

• Patient Access Representatives facilitate a welcoming and smooth entry process for patients accessing hospital services. They are responsible for creating patient encounters and ensuring accurate entry of demographic and financial data. The role includes insurance verification, authorization for services, and collection of patient payments, including prior balances.
• Patient Access staff play a key role in the financial success of patient services and ensure compliance with Federal regulations, JCAHO, and Department of Health and Hospital standards. They communicate with patients, families, physicians, nurses, insurance companies, and third-party payers.
• This position requires professionalism, strong communication skills, organizational ability, dependability, flexibility, and teamwork.

Responsibilities:

General Expectations

• Meets expectations of OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Represents the Patient Access department in a professional and courteous manner at all times.
• Supports departmental performance targets and operational goals.
• Completes required training as needed and mandated.
• Maintains adherence to established standard processes and procedures.
• Participates in maintaining a clean, organized, and efficient workplace (5S principles, HPWT).
• Works with High Performance Work Teams (HPWT) to support workflow efficiency.
• Assists in disaster situations (internal or external) when required.
• Supports flexible scheduling needs, including reassignment and shift changes.
• Performs other duties as assigned.

Patient Registration & Data Management

• Accurately inputs all required data elements for scheduling and registration.
• Includes patient demographic, financial, guarantor information, and relevant encounter notes.
• Ensures data accuracy and completeness for all accounts.

Insurance & Financial Duties

• Verifies insurance eligibility.
• Obtains necessary authorizations for services.
• Calculates and collects estimated patient responsibility based on benefits, contracts, and prior balances.
• Performs financial assessments for assistance program eligibility.

Patient Communication & Documentation

• Communicates purpose of hospital documents clearly to patients/legal guardians.
• Obtains required signatures on all necessary forms.
• Communicates effectively with patients, families, medical staff, insurance companies, and third-party payers.

Compliance & Confidentiality

• Ensures compliance with all hospital policies, federal/state regulations, and accrediting bodies.
• Protects patient confidentiality at all times.
• Does not disclose or solicit confidential information outside job requirements.

Patient-Centered Care

• Demonstrates competency in serving diverse patient populations.
• Adapts services to meet physical, psychosocial, cultural, age-specific, and developmental needs.

Teamwork & Workflow Support

• Coordinates and assists in managing workflow during fluctuating patient volumes.
• Provides feedback regarding issues, problems, and improvement opportunities (IPOs).
• Supports team communication and identifies educational or mediation needs.

Job Requirements:

Education:

• High School Diploma or equivalent (preferred)

Experience:

• 1–3 years of related experience (preferred)