Pre-Access Representative

Canton-Potsdam Hospital Canton, NY 2019-06-27

Job Summary

The Patient Access Scheduler/Pre-Registration Clerk will be responsible for handling the flow of scheduling calls. The essential responsibilities include pre-registration, scheduling, obtaining accurate demographics, providing exam preparations, and collection of appropriate authorizations/ICD codes in a courteous and efficient manner. They will be responsible for completing accounts with eligible insurance and authorization and complete patient pre-registration for scheduled procedures. The Representative will verify the patient payer eligibility, benefits/coverage, and estimated payment responsibility, confirm authorization requirements and secure on the account. The Representative will complete pre-registration phone interviews, to include obtaining necessary pre-registration information, including demographics, insurance information, and Medicare MSPQ, with documentation completed in the electronic medical record account. During the pre-registration interview, the representative will notify patient of potential financial responsibility and collect payment via phone, review issued Medicare ABN (Advance Beneficiary Notification), provide direction to facility and registration desk, and educate the patient regarding what items are required as part of the patients facility registration process.

Core Responsibilities

Responsible for interviewing incoming patients for all patient types, preparing and processing pertinent patient information, to include demographics and insurance verification & authorization.

Answers phones from patients/customers professionally and responding to patient/customer inquiries and complaints.

Schedules patients/customers based on scheduling guidelines and medical appropriateness.

Receives a high volume of inbound calls with varying degrees of questions or concerns.

Obtaining and collecting all necessary information from the patient/customer to schedule and register the patient for an appointment.

Identifies and communicates need for scheduling modifications and development.

Consults with referring physician’s office to ensure written and/or electronic orders exist and obtain them as needed.

Participates in on-going education activities to develop, maintain, and enhance professional expertise as monitored by supervision.

Performs all registration functions and processes supporting Canton-Potsdam Hospital including conducting patient interviews, pre-registration/registration, collecting and verifying demographic and financial data, accurately entering system required information, completing the financial clearance process and system-related tasks to register patients.

Registers/Pre-Registers patients in the appropriate Electronic Medical Record (EMR) system and utilizes various software and online electronic insurance verification systems to complete financial clearance and authorization/referral purposes.

Completes documentation according to Canton-Potsdam Hospital and Gouverneur Hospital policies and procedures and the requirements of Corporate Compliance, local, state, and federal agencies, the Department of Health (DOH); and the Joint Commission (e.g. ABN, MSP, Advanced Directives, patient rights, HIPPA, Red Flag, ICD & CPT coding).

Required Experience:

1-2 years of outpatient practive admissions or equivalent experience required.
Customer service experience required.
Experience with computer applications required.

Preferred:Knowledge of health care insurance and managed care preferred.

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