Patient Access Rep I
On-siteNorwalk, Ohio, United States
Job Summary
Field and direct incoming calls, respond to patient and staff inquiries, and initiate patient triage slips when necessary. Ensure registration and admission forms are ready for patients upon arrival, while greeting all individuals with respect. Gathers and verifies confidential health and financial information using computer software to assure payment for authorized services. Enters new patient data, verifies electronic medical records, and files protected health information in accordance with organizational systems. Verifies insurance eligibility, obtains pre-authorizations from third-party payers, and communicates coverage details to patients. Complies with HIPAA and other federal laws regarding patient privacy and confidentiality. Performs other clerical duties as assigned while maintaining a safe environment.
Required Qualifications
- Proficient customer-service skills
- Knowledge of safety policies and procedures
- Demonstrated professionalism in appearance, speech, and conduct
- Understanding of insurance protocols for referrals, co-payments, and deductibles
- Knowledge of the Health Insurance Portability and Accountability Act (HIPAA)
- Ability to verify insurance eligibility and benefits
- Ability to obtain pre-authorizations from third-party payers
- Ability to verify medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards
- Ability to identify patients who will need Medicare Advance Beneficiary Notices (ABNs)
- Ability to maintain accurate records of authorizations
- Ability to file protected health information (PHI) in accordance with Fisher-Titus's filing system
- Ability to enter new patient data and/or verify patient records
- Ability to confirm the completeness of the electronic medical record (EMR)
- Ability to make changes to records as necessary
- Ability to comply with all organizational, state, and federal laws and registrations related to patient privacy and confidentiality
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