Patient Access Representative

Patient Access Representative

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Working in Patient Access and as a member of the Beth Israel Lahey Health (BILH) System Services team, you can have a career that allows you to grow and advance while making a difference in people's lives. We use a coordinated approach to delivering administrative and operational services across our entire healthcare system. By leveraging resources across the organization, we're able to provide high-quality, high-value care to the patients and the communities we proudly serve. The Patient Access Representative ensures that the patient experience in accessing healthcare at BILH is efficient and welcoming, and that patient confidentiality is respected and patient safety is preserved. Performs a variety of functions to support an accurate, safe, and customer-focused registration process, either electronically, telephonically or in person. The Patient Access Representative ensures that all proper patient financial and demographic information is obtained and processed so BILH is fully reimbursed for clinical services provided. The Patient Access Representative handles patient questions and requests accurately and efficiently, ideally with first-call resolution, or by making appropriate referrals to other departments, based on the original purpose of the question and any other questions or requests subsequently disclosed by the patient. Extensive training including Electronic Health Record (EHR) is provided. Our team works in a fast-paced, collaborative environment, helping our patients navigate their healthcare journey.

Job Description :

Essential Duties & Responsibilities including but not limited to :

Registration :

1. Registers patients presenting for visits. Explains the registration process to patients and responds to patient questions.

2. Processes patient co-payments, co-insurance, deductibles, and balances due. Safeguards cash, checks and receipts and reconciles cash drawer at the end of each business day. Assists patients with Kiosk check-in as needed.

3. Completes the Medicare Secondary Payer Questionnaire for each patient and adjusts patient coverage based on results.

4. Instructs patients and obtains signatures on consent forms, financial forms, and other documents required by the clinical department; distributes documents to patients; scans, processes, and records receipt of all documents collected during registration encounter.

5. Counsels patients regarding non-covered services, obtaining signatures on Advance Notice Beneficiaries (ABNs), consents and waivers.

6. Monitors patient waiting area for a smooth, efficient registration flow. Advises patients of potential delays and takes steps to ensure a pleasant patient experience.

7. Responds to patient concerns and potential patient safety issues accordingly. Recognizes health conditions that are a possible risk to others and adheres to appropriate established procedures to help contain risk.

8. Assures a neat, orderly registration desk and patient waiting area, securing all confidential patient information.

Scheduling :

9. Initiates patient scheduling activities by prioritizing and accessing a variety of sources, including patient phone calls and digital messaging, orders, scheduled order work queues.

10. Utilizes a variety of information sources to schedule, reschedule, and cancel patient appointments. Information sources include online questionnaires, offline materials, and subgroup searches.

11. Establishes working relationships with staff of assigned clinical departments. Understands and correctly applies unique clinical department scheduling protocols.

12. Remains current on scheduling protocols and applies judgment, or seeks management assistance, to ensure safe patient care when clinical department scheduling protocols do not meet patient needs.

13. Ensures all required key patient scheduling and registration information is captured and verified. Key information includes referring physician information, insurance coverage, demographics, and contact information.

14. Identifies and communicates to Patient Access management issues that may impact the timeliness and accuracy of patient appointments and subsequent patient care.

15. Strictly follows confidentiality and equipment security and safeguarding guidelines when working in a remote setting. Maintains productivity, quality, and accuracy levels and communicates regularly with the Supervisor and Manager. Pre-Registration :

16. Efficiently registers patients, capturing and verifying all required information in order to identify the patient, contact the patient, and receive proper reimbursement for services on initial claim submission.

17. Ascertains, creates, and assigns the guarantor for each patient, including personal / family relations, workers compensation insurance, third parties, behavioral health, or others as required.

18. Identifies records and verifies patient insurance coverage using real-time eligibility (RTE); reviews the insurer's response to each verification request and takes appropriate action based on this response.

19. Applies the appropriate guarantor and insurance to each patient visit.

20. Communicates financial clearance status to patients. Advises patients of contract status, self-pay status, and payment responsibility and schedules patients with Financial Counseling as needed.

Minimum Qualifications :

Education : High school degree or equivalent. Associate's degree preferred.

Licensure, Certification & Registration : None

Experience : 1-3 years related work experience. Experience with computer systems required, including web-based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint, or Access.

Skills, Knowledge & Abilities : Able to work successfully in a fast-paced, multi-task environment, where some independent decision-making is necessary. Able to process electronic information and data accurately and efficiently.

Preferred Qualifications & Skills :

Call Center and / or telephone customer service experience Strong typing skills 40+wpm. Knowledge of medical terminology Bilingual written and verbal communication skills Familiar with EHR Software

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.