Patient Access Representative Resume Samples

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JB
J Bernier
Jade
Bernier
21213 Benedict Stream
Philadelphia
PA
+1 (555) 118 6512
21213 Benedict Stream
Philadelphia
PA
Phone
p +1 (555) 118 6512
Experience Experience
03/2016 present
Dallas, TX
Ohi Patient Access Representative
Dallas, TX
Ohi Patient Access Representative
03/2016 present
Dallas, TX
Ohi Patient Access Representative
03/2016 present
  • May assist with onboarding and training new team members; acts as a mentor to motivate and support staff in performing daily duties
  • Perform business office functions (clerical, environmental, and organizational) under the supervision of the Practice Manager/Supervisor
  • Contribute to overall patient satisfaction by consistently providing superior customer service to all patients and their families
  • Perform routine EMR audits to ensure all procedures are billed for and monitor reports to ensure compliance
  • Verify insurance coverage and eligibility; respond to patient inquiries regarding basic insurance questions
  • Adhere to, and remain compliant with, state/federal guidelines pertaining to HIPAA standards
  • Demonstrate a sense of urgency to all tasks and respond accordingly
10/2012 01/2016
Los Angeles, CA
Patient Access Representative IV
Los Angeles, CA
Patient Access Representative IV
10/2012 01/2016
Los Angeles, CA
Patient Access Representative IV
10/2012 01/2016
  • The specific job duties will be comprised of a combination of responsibilities from among the various areas of PAS operations including: On-site, Ancillary, Financial Counselor, Acess Unit, and Emergence Department Registration
  • Maintains professional communication with various PAS staff, medical center staff, physicians, guests, and patients regarding the admitting services rendered at Stanford Medical Center. Communication may consist of telephone correspondence or in person contact
  • Performs other duties and responsibilities as assigned by the unit team manager or other PAS management personnel
  • Provide assistance with the monthly staffing schedule
  • Performs Lab Intake which includes Laboratory blood draw check in and accessioning. (SHC ONLY)
  • Meets weekly individual productivity goals and standards while following planned priorities as set by the Team Manager/Coordinator
  • Performs Radiology intake which includes accessing RIS database to verify and/or release orders, schedule, and track appointments. (SHC ONLY)
05/2007 04/2012
Philadelphia, PA
Patient Access Representative
Philadelphia, PA
Patient Access Representative
05/2007 04/2012
Philadelphia, PA
Patient Access Representative
05/2007 04/2012
  • Educating the patient regarding their rights, advance directives, system services, and other patient services
  • Typing speed of 35 wpm
  • Working knowledge of Protected Health Information (PHI), HIPPA
  • Navigating electronic health records
  • Escorting patients to area of service
  • Efficiently and accurately utilizes necessary technology to perform job tasks
  • Secures medical necessity checks/verification in accordance to Centers for Medicare & Medicaid services, verifies insurance, benefits, coverage & eligibility, completes assigned registration financial clearance work lists activities, obtains insurance authorizations for scheduled & unscheduled Hospital services, and secures inpatient visit notification to payors. May also assist with scheduling and coordinating post discharge care for patients
Education Education
Bachelor’s Degree in Accuracy
Bachelor’s Degree in Accuracy
Carnegie Mellon University
Bachelor’s Degree in Accuracy
Skills Skills
  • Knowledgeable and experience with various computer systems; Ability to use a 10-key calculator and computer keyboard
  • Ability to multi-task, have attention to detail, strong organization skills, and a team player
  • Knowledgeable and experienced with various computers systems; Ability to use a 10-key calculator and computer keyboard
  • Excellent critical thinking skills with ability to independently resolve problems
  • Strong organizational skills; attention to detail
  • Excellent verbal and written communication including professional one-on-one interactions and phone skills
  • Strong attention to detail
  • Strong organization skills; attention to detail
  • Ability to work in a fast-paced, professional environment
  • Ability to incorporate excellent customer service skills in dealing with patients, personnel, physicians, and peers
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1

Patient Access Representative Resume Examples & Samples

  • 1+ year of Administrative / Clerical experience in a high volume Customer Service office
  • Previous experience as a Patient Access Representative
  • Familiar with Medical Terminology
2

Ohi Patient Access Representative Resume Examples & Samples

  • Adhere to, and remain compliant with, state/federal guidelines pertaining to HIPAA standards
  • Process referrals and arrange for laboratory/diagnostic services
  • Perform routine EMR audits to ensure all procedures are billed for and monitor reports to ensure compliance
3

Patient Access Representative Per Diem Emergency Department Resume Examples & Samples

  • Experience within a hospital or clinic environment, an insurance company, managed care organization or other financial service setting, performing financial counseling, financial clearance and/or customer service activities as typically acquired in two years
  • Completion of regulatory/mandatory certifications and skills validation competencies preferred
  • Excellent time management skills and the ability to manage frequent in-person patient contacts while effective maintaining and documenting data in the patient registration systems
  • Strong data entry skills required
  • Excellent verbal and written communication and active listening skills
  • Interpersonal skills necessary in dealing with internal and external customers
4

Patient Access Representative ER Per Diem Resume Examples & Samples

  • One year acute Emergency Department experience as an admitting clerk(registration)
  • General knowledge of patient access functions in acute and non-acute settings preferred
  • Working knowledge of medical terminology recommended
5

Patient Access Representative Resume Examples & Samples

  • High-level knowledge of Government regulations and requirements, managed care contracts and third party requirements
  • Demonstrated knowledge of the PRS and medical office / hospital admission processes
  • Basic knowledge of medical terminology
  • Excellent English communication skills in both written and verbal formats
  • General understanding of Patient Registration Systems
  • Ability to identify patients that may need financial assistance and make referrals to appropriate resources
  • One year of prior hospital or medical registration experience
  • Must be able to interview patients / family to obtain the required patient and guarantor demographic and insurance information
  • Must be able to accurately and efficiently enter this information into the Patient Registration system
6

Patient Access Representative Resume Examples & Samples

  • Performs insurance verification and re-verification of insurance
  • Communicates in writing or via telephone with patients, family members, physicians and insurance representatives on eligibility requirements, policy benefits, eligibility determinations and contract provisions
  • Maintains accurate and complete documentation of all contacts
  • Receive, sort, identify, stamp and log faxed/mailed prior authorization requests
  • May distribute incoming mail and fax correspondence to physicians
  • Provides administrative support to the prior authorization team including updating and maintaining forms used by the department
  • Review co-pay assistance program information to perform verification for patient eligibility by contracting programs to confirm funding information
  • Completes other projects and additional duties as assigned
  • High school diploma or GED required, bachelor’s degree preferred
  • 0-1 years of relevant working experience; health insurance experience with medical insurance knowledge and terminology is preferred
  • Excellent telephone presentation and communication skills
  • Demonstrated ability to handle challenging customers in a professional manner with the ability to adapt in a dynamic work environment
  • Solid problem solving skills and the ability to work collaboratively with other departments to resolve issues with innovative solutions
7

Patient Access Representative Resume Examples & Samples

  • Collects appropriate co-pays, deposits and issues receipts. Completes Registrations in accurate and timely manner with 97% accuracy. Ensure all authorizations and signatures are obtained. Completes third party payer forms
  • Contacts employers for worker's compensation cases to obtain and document carrier information
  • Documents information in computer systems. Makes copies as needed
  • Notifies department or nursing station of patient's arrival. May transport patient to a department
  • Provides excellent customer service to patient, family and visitors
  • Provides functional guidance and direction to new employees
  • Knowledge of insurance authorization required to include Managed Care, Medicare, and Medi-Cal and other commercial payers requirements
  • Medical terminology required and expertise must be demonstrated
  • Knowledge of Patient Registration Process required
  • Knowledge of EMTALA and Consent Laws required
  • Use of Microsoft Outlook e-mail required
  • Knowledge of Community Resources required. Effective verbal and written English skills
  • Knowledge to utilize all IT applications within the Patient Access department, including,
  • But not limited to MS4, Document Imaging, Navicare, Internet Insurance Verification, AETS, Kronos, eLearning, Public Folders, etc
  • Ability to understand variances in payer requirements based on type of service and/or procedure, for inpatients and outpatients preferred. Ability to effectively communicate payer requirements to patients and/or patients’ family members
  • Ability to maintain quality standards and proficient performance standards during high activity and/or stressful situations required
  • Demonstrated ability to organize/prioritize and handle multiple demands and interruptions while maintaining a high energy, flexible, and optimistic attitude
  • Use of industry utilized insurance verification systems (HDX, IDX, and POS, etc.) an
  • Asset
  • Demonstrated ability to utilize a variety of computer applications and access specific Internet Web sites for information and become competent in any other new technology that is introduced and becomes departmental standard
  • Able to work independently. Ability to maintain quality standards and proficient performance standards during high activity and /or stressful situations must be demonstrated
8

Patient Access Representative Resume Examples & Samples

  • Typing speed of 35 wpm
  • Ability to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles
  • Demonstrates interpersonal communication skills necessary in interacting with internal and external customers
  • Professional attire required at all times
  • Strong data entry skills and computer proficiency are required
  • Ability to work and maintain confidential information
  • Ability to set and organize own work priorities and adapt to change
  • Must demonstrate excellent verbal, written interpersonal communication, active listening, and problem solving skills
9

Patient Access Representative Resume Examples & Samples

  • Greets & registers patients for various medical services in the hospital setting potentially in a 24 hour, 7 day a week environment & in a highly active fast paced setting such as the Emergency department. Pre-registers patients where applicable
  • Performs minimal eligibility verification & resolves discrepancies as able or defers to appropriate resource, identifies need for financial assistance recommendation & application, referring to the Financial Counselor where necessary
  • Verifies the patient demographic & insurance information with the patient consistent with CMS regulations, the National Registration Standards & regional policies
  • Verifies members eligibility & benefits from identified insurance plan(s) prior to or upon admission to the hospital, using computer based verification programs, as available
  • Uses problem-solving skills to verify patient identification through patient name, spouse names, SSN, DOB & address in order to identify & minimize duplicate medical records
  • Interview patient to obtain/determine appropriate insurance carrier & identifies, verifies, & inputs Other Coverage Information (OCI), primary, secondary, & tertiary payers for services provided
  • Performs registration function for all patient class & clinical services
  • Determines & collects cost-shares, & partial payments for services to be received. Enter/verify payments in the computer, close cash drawers, count currency, checks, & credit card payments at the end of each shift, & create deposits per cash handling policies
  • Provides patient liability information & collects the point of service cash from patients based on guidelines and/or systems provided by the department, including but not limited to
  • One (1) year health care financial AND one (1) year office environment customer service OR two (2) years post high school related education OR combination of education and experience
  • Previous experience with cash handling required
  • Previous hospital or ambulatory clinic registration experience preferred
  • Obtains training to become a Certified Healthcare Access Associate by the National Association of Healthcare Access Management within 180 days of employment preferred
10

Patient Access Representative Tracy Resume Examples & Samples

  • Six (6) months experience within a hospital or clinic environment, an insurance company, managed care organization or other financial service setting, performing financial counseling, financial clearance and/or customer service activities
  • Ability to work in multiple computer systems, such as patient registration/accounting systems, document imaging, scanning, payment posting, proprietary payer websites and data quality monitoring, both accurately and efficiently
  • Strong accuracy and attentiveness to detail skills required
  • Ability to meet and exceed targeted customer service, productivity, and quality standards
  • Ability to read, write, hear, and verbally communicate in English to the degree necessary to successfully perform the job
  • General knowledge of patient access financial counseling functions in acute and non-acute settings preferred
  • Previous knowledge of insurance billing
11

Patient Access Representative Resume Examples & Samples

  • Performs registrations by completing an accurate face to face interview to obtain demographic, insurance, medical and financial information
  • Cross-trained to staff all areas of Patient Access at any facility, including but not limited to, Front Desk, Admitting Office, ED and Cashier
  • Maintains productivity and quality standards
  • Acts as a resource for training of new team members and during the implementation of new processes
  • Minimum of 2 years of experience in a customer facing role with in person or phone contact
  • An Associates degree may substitute for up to one year of the stated experience
12

Patient Access Representative Days Resume Examples & Samples

  • Minimum typing skills of 35 wpm
  • Demonstrated working knowledge of PC/CRT/printer
  • Knowledge of function and relationships within a hospital environment preferred
  • Customer service skills and experience
  • Ability to work in a fast paced environment
  • Ability to receive and express detailed information through oral and written communications
  • Understanding of Third Party Payor requirements preferred
  • Understanding of Compliance standards preferred
  • Must be able to perform essential job duties in at least two Patient Access service areas including ED
  • Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors
  • Builds and maintains collaborative relationships with both internal and external Clients that lead to more effective communication and a higher level of productivity and accuracy
  • Must be able to appropriately interpret physician orders, medical terminology and insurance cards while maintaining Conifer Standards of Care
  • High School Diploma or GED required
  • 0 – 1 year in a Customer Service role
  • 0 – 1 year administrative experience in medical facility, health insurance, or related area preferred
  • Some college coursework is preferred
  • Must be able to sit at computer terminal for extended periods of time
  • Occasionally lift/carry items weighing up to 25 lbs
  • Frequent prolonged standing, sitting, and walking
  • Occasionally push a wheelchair to assist patients with mobility problems
  • Hospital administration
  • Can work in patient care locations which include potential exposure to life-threatening patient conditions
  • Must be available to work hours and days as needed based on departmental/system demands
  • Resolves Physician's office and Patient issues. May experience extreme patient volumes and uncooperative Patients
13

Patient Access Representative Carondelet Resume Examples & Samples

  • 1 Schedule and register all patients to the hospital. Follow all booking directions and scheduling tools as applicable to ensure prompt, accurate, and timely appointments
  • 2 Record appropriate insurance information and notify third-party payer for prior-authorizations as contractually dictated
  • 3 Obtain needed physician information as necessary
  • 4 Coordinate efforts with Financial Counselors
  • 5 Maintain all confidentiality of all patient information and release information only as outlined in appropriately signed Conditions of Admissions. Adhere to all CMS, JCAHO, OSHA, EMTALA and Infection Control requirements pertaining to the admitting process
  • 6 Obtain, verify, and accurately enter all patient information received from patient or family member as needed for registration
  • 7 Assign and record appropriate insurance information and notify third party payers as directed by contractual agreement and document in the system
  • 8 Coordinate multiple activities seamlessly to show effective operations
  • 9 Provide exemplary customer service to each patient and family member. 1.10 Ensure all required information is obtained and entered to ensure the billing of the identified revenue source
  • 11 Partner with the Billing Office to provide and exchange information
  • 12 Meet the productivity and quality standard of the department
  • 13 Develop and maintain office organization including filing system, record keeping, messaging, and clean work environment
  • 14 Maintain par levels of form supplies necessary for efficient operations. 1.15 Assist in training of new employees as assigned
  • 16 May assist with the the coordination of activities, such as insurance pre-certification/authorization and resource usage and changes
  • 17 Maintains a working knowledge of CPT and ICD-9 coding principles, governmental regulations protocols and third party requirements billing documentation. Ensures all services are documented on the Encounter Form are with appropriate and/or legible diagnosis code(s)
14

Patient Access Representative Resume Examples & Samples

  • Facilitates cross-functional resolution of drug coverage issues & proactively address, researches & resolves issues impacting revenue optimization
  • Performs medical /pharmacy benefit verification requiring complex decision skills based on payer and process knowledge resulting in on boarding or no starting a specialty patients
  • Contacts benefit providers to gather policy benefits/limitations; coordinating and ensuring services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.). Directly interfaces with external clients
  • Provide expert assistance to clients on patient status. Liaison for company providing referral status reporting
  • May negotiate pricing for non-contracted payers and authorize patient services and ensure proper pricing is indicated in RxHome. Handle Escalations. Use discretion & independent judgement in handling pt or more complex client complaints, escalating as appropriate
  • 3-5 years of relevant working experience; Health care experience with medical insurance knowledge and terminology and experience in patient access preferred
  • Intermediate data entry skills and working knowledge of Microsoft Office, Patient Access knowledge
  • Extensive knowledge of ESI products and services a must; Experience training and coaching less experienced staff with patience to explain details and processes repeatedly; Excellent phone presentation and communication skills; Demonstrated ability to handle challenging customers in a professional manner; Ability to adapt in a dynamic work environment and make decisions with minimal supervision; Advanced problem solving skills and the ability to work collaboratively with other departments to resolve issues with innovative solutions
15

Patient Access Representative hrs Nights Resume Examples & Samples

  • Greets patients/family members and obtains and/or verifies demographic, clinical, financial, and insurance information in the process of financially clearing patients for service delivery, including the entry of patient/guarantor information in the patient registration/accounting systems, collection of patient signatures on all appropriate forms and the imaging/copying of registration documents
  • Utilizes inputs to authenticate and register patients for service delivery for patients who have registered through the Patient Access Center; for those who are not registered, completes the end-to-end process of registration through close-out for service delivery
  • Conducts insurance eligibility/benefit verification, referral/authorization, and financial education on designated accounts
  • Calculates estimated patient liability, informs patient/guarantor and actively collects and/or processes patient payments
  • Refers appropriate cases to financial counseling for follow-up and consultation
  • Executes other duties as assigned, such as cashiering, bed management, and communications
  • Enhances the patient experience throughout all patient interactions, which will be face-to-face, demonstrating knowledge of Sutter’s Health system and service offerings
16

Patient Access Representative Resume Examples & Samples

  • Minimum 90 days training of experience as Admissions Specialist-Trainee
  • Proficient with the Meditech system, showing ability to enter and retrieve data
  • Ability to work effectively with patients, family members and staff
  • Strong detail and follow-up skills
  • Ability to concentrate and focus on assigned tasks in the face of high volume with many interruptions
  • Ability to cross train for support of other positions with Registrations/PBX areas
17

Associate Patient Access Representative Resume Examples & Samples

  • Verify patient demographics and activate patients in the system of record upon arrival on the date of service, if the patient has been pre-registered
  • Ensure required/applicable forms and documents are presented and explained during time of registration (e.g., Patient Rights and Responsibilities, Advance Directives, Important Patient Information, etc.)
  • Assist patients and customers in navigating throughout the hospital facility
  • 2 years registration experience preferred
  • Previous experience with Meditech system
18

Patient Access Representative Resume Examples & Samples

  • Collects, enters and completes corrections of required data into the legacy ADT system with emphasis on accuracy of demographic and financial information ensuring appropriate revenue routing
  • Verifies third party payor through the electronic insurance verification system. Ensures complete, accurate and timely entry of third party payor information into legacy ADT system
  • Interviews self-pay patients to identify those presumptively eligible for Medicaid and/or charity based on SJHS policy
  • Enters all pre-certification and/or authorization numbers into legacy ADT systems if applicable
  • Determines ICD9 codes for electronic insurance verification systems
  • Determines patient and payor financial responsibilities at time of service
  • Collects the patient co-pays, deductibles and other patient's financial liability at the time of registration
  • Notifies UR Dept of non-authorized procedures/services for appropriate patient care decisions
  • Contributes to quality control mechanisms and increases opportunity for a "clean" bill by reconciliation of demographic and financial data
  • Promotes a customer service orientation in the performance of position duties and responsibilities and in interactions with patients, hospital staff and visitors
  • Obtains complete and accurate data from third party payors, i.e. insurance copies, letters of sponsorship verification and managed care/HMO authorizations
  • Answers inquiries via phone or in person and routes to appropriate department
  • Participates actively in all education opportunities provided by managers
  • Ability to deal tactfully with associates, patients, visitors and the general public
  • Ability to problem solve independently
  • Strong clerical and organization skills
  • Ability to interact with upset clients and behave in a professional manner
  • Ability to maintain strict confidentiality at all times
  • Knowledge of third party requirement preferred
  • Bilingual capabilities preferred
  • College or Vocational education
  • Insurance experience in billing, verification and/or eligibility determination
  • Experience in provided values-based customer service
19

Patient Access Representative Resume Examples & Samples

  • Answer a multi-line phone system in a professional manner and route calls to the appropriate department
  • Schedule physician appointments to include, follow-up appointments, diagnostic procedures and specialty physician referrals
  • Accurately update patient demographics in the professional system of record upon arrival on the date of service and assist patients and customers in navigating throughout JACC
  • Ensure that required/applicable forms and documents are presented, explained, and signed at the time of registration (e.g., Patient Rights and Responsibilities, Advance Directives, Important Patient Information, etc.)
  • Queue patients upon completion of demographics and insurance information, in the professional software system, to the appropriate department (e.g., infusion, laboratory, physician office)
  • Obtain professional point of service collections according to pre-set goals and targets
  • Assist patients with on-site customer service functions (e.g., billing, release of information and collection inquiries) by coordinating with other revenue cycle functions and departments
  • Knowledge of patient financial clearance for the professional component prior to the office visit
  • Key activities include: Components of referral/authorization, self pay clearance, charity clearance for professional office visit and escalating unresolved issues to appropriate leadership level
  • Experience: Minimum of 1 year in health care office experience or related field preferred
  • 1 year of out-patient registration experience preferred
  • Familiarity with basic financial clearance functions
  • Bilingual English/Spanish speaking
20

Patient Access Representative Overnight Resume Examples & Samples

  • Minimum typing skills of 35 wpm
  • Demonstrated working knowledge of PC/CRT/printer
  • Knowledge of function and relationships within a hospital environment preferred
  • Customer service skills and experience
  • Ability to work in a fast paced environment
  • Ability to receive and express detailed information through oral and written communications
  • Understanding of Third Party Payor requirements preferred
  • Understanding of Compliance standards preferred
  • Must be able to perform essential job duties in at least two Patient Access service areas including ED
  • Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors
  • Builds and maintains collaborative relationships with both internal and external Clients that lead to more effective communication and a higher level of productivity and accuracy
  • Must be able to appropriately interpret physician orders, medical terminology and insurance cards while maintaining Conifer Standards of Care
  • High School Diploma or GED required
  • 0 – 1 year in a Customer Service role
  • 0 – 1 year administrative experience in medical facility, health insurance, or related area preferred
  • Some college coursework is preferred
  • Must be able to sit at computer terminal for extended periods of time
  • Occasionally lift/carry items weighing up to 25 lbs
  • Frequent prolonged standing, sitting, and walking
  • Occasionally push a wheelchair to assist patients with mobility problems
  • Hospital administration
  • Can work in patient care locations which include potential exposure to life-threatening patient conditions
  • Must be available to work hours and days as needed based on departmental/system demands
  • Resolves Physician's office and Patient issues. May experience extreme patient volumes and uncooperative Patients
21

Patient Access Representative Resume Examples & Samples

  • Performs all aspects of electronic claims process and rejection resolution
  • Ensures accounts requiring authorizations and re-authorizations are identified, secured, and updated in RX Home prior to each shipment. Notifies as appropriate if authorization cannot be obtained
  • Contacts benefit providers to gather policy benefits/limitations to ensure services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.)
  • Handles inbound client calls and written correspondence regarding patient eligibility
  • Provides inbound phone call support to the prior authorization team giving personal attention to the resolution of customer issues having to do with the status of letter requests or physician review process
  • Supports cross-functional departments in resolution of eligibility issues (claims, contact center, account management, service delivery, etc.)
  • Negotiates pricing for non-contracted payers and authorizes patient services and ensures proper pricing is indicated in RxHome. Works referrals
  • 2-3 years of relevant working experience to include one year of health care experience with medical insurance knowledge and terminology
  • Extensive knowledge of Express Scripts products and services a must
  • Experience training and coaching less experienced staff with patience to explain details and processes repeatedly
  • Excellent phone presentation and communication skills
  • Demonstrated ability to handle challenging customers in a professional manner, ability to adapt in a dynamic work environment and make decisions with minimal supervision
  • Advanced problem solving skills and the ability to work collaboratively with other departments to resolve issues with innovative solutions
22

Patient Access Representative Resume Examples & Samples

  • Interpersonal relationships; relates well with hospital staff, medical staff and public
  • Positive attitude and cooperative toward his/her position, the hospital and fellow employees. Computer skills: Word, Excel, 10-key by touch
  • Typing 35 WPM preferred
  • Basic English and Mathematical skills
23

Patient Access Representative 8am to 8pm Thurs Fri Sat Resume Examples & Samples

  • Minimum typing skills of 35 wpm
  • Demonstrated working knowledge of PC/CRT/printer
  • Knowledge of function and relationships within a hospital environment preferred
  • Customer service skills and experience
  • Ability to work in a fast paced environment
  • Ability to receive and express detailed information through oral and written communications
  • Understanding of Third Party Payor requirements preferred
  • Understanding of Compliance standards preferred
  • Must be able to perform essential job duties in at least two Patient Access service areas including ED
  • Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors
  • Builds and maintains collaborative relationships with both internal and external Clients that lead to more effective communication and a higher level of productivity and accuracy
  • Must be able to appropriately interpret physician orders, medical terminology and insurance cards while maintaining Conifer Standards of Care
  • High School Diploma or GED required
  • 0 – 1 year in a Customer Service role
  • 0 – 1 year administrative experience in medical facility, health insurance, or related area preferred
  • Some college coursework is preferred
  • Must be able to sit at computer terminal for extended periods of time
  • Occasionally lift/carry items weighing up to 25 lbs
  • Frequent prolonged standing, sitting, and walking
  • Occasionally push a wheelchair to assist patients with mobility problems
  • Hospital administration
  • Can work in patient care locations which include potential exposure to life-threatening patient conditions
  • Must be available to work hours and days as needed based on departmental/system demands
  • Resolves Physician's office and Patient issues. May experience extreme patient volumes and uncooperative Patients
24

Patient Access Representative Resume Examples & Samples

  • Demonstrates ability to effectively communicate (written & oral) with individuals and groups of various backgrounds and educational levels in high stress situations
  • Demonstrates ability to manage multiple, changing priorities in an effective and organized manner, under stressful demands while maintaining exceptional customer service
  • Obtains complete and accurate demographic, insurance and financial data to complete registration
  • Updates and maintains patient database according to established procedures
  • Completes and balances all daily transaction paperwork
  • Maintains consistent and professional attendance, punctuality, personal appearance, and adherence to relevant health & safety procedures
  • Minimum of two years of face to face customer service experience is required
  • Experience providing customer service to patients and their families is preferred
  • Experience working with patient records and charts and an understanding of insurance plans is preferred
  • Ability to incorporate excellent customer service skills in dealing with patients, personnel, physicians, and peers
  • Must be self-driven and possess the ability to work in teams with minimal daily supervision
  • Ability to work in a fast-paced, professional environment
25

Patient Access Representative Resume Examples & Samples

  • Demonstrates ability to effectively communicate (written and oral) with individuals and groups of various backgrounds and educational levels in a high stress environment
  • Inform patients of hospital rates, rules and regulations and answers patients’ questions. If unable to answer questions, investigates all avenues available to resolve concerns
  • Assists in training new employees for the admitting responsibilities. Performs clerical duties, computer operational duties, filing, record keeping, answering phones, while demonstrating exceptional customer service
  • Addresses questions and requests regarding financial assistance. Collects any payment due upon admission and assures insurance verification process is completed. Complete and balance all daily transaction paperwork
  • Maintain consistent and professional attendance, punctuality, personal appearance, and adherence to relevant health & safety procedures
  • Ability to flex schedule to meet the department needs to include longer scheduled shifts and may include night, weekend and holiday coverage
  • Current BLS for the Healthcare Provider preferred, must have complete within 60 days of hire
  • Insurance verification experience and understanding of insurance plans is preferred, as well as obtaining pre-authorizations and pre-certifications
26

Patient Access Representative PRN Resume Examples & Samples

  • Exhibits a high level of empathy with the ability to effectively communicate with patients and family members during traumatic events, while demonstrating exceptional customer service skill
  • Reviews and processes patient registration forms and ensuring they contain all necessary documents. Verifies Demographic and insurance information. Obtains all necessary signatures. Inputs patient information into computer to produce patients/ labels, account number, and forms. Scans at time of registration all insurance cards, state I.D., Advance Directives and other signed registration forms
  • Obtains pre-authorization and pre-certification as needed
  • Follows and maintains current knowledge of company and department policies and procedures
  • All members of the team are responsible for ensuring the facility is cleaned and well maintained
  • High school diploma or equivalent is required; some college is preferred
  • Must have a current card from an American Heart Association (AHA) recognized course. Note: exclusively online courses are not offered by the AHA
  • CHAA certification preferred
  • Ability to communicate in a clear, concise, and organized manner and interpret a variety of instructions furnished in written, oral, diagram, or schedule form
  • Proficiency in Microsoft Office is required
27

Patient Access Representative Resume Examples & Samples

  • Use of computer to fulfill essential functions of job required
  • Customer service experience desired
  • Medical office experience desired
  • Ability to type 35 word per minute desired
28

Patient Access Representative Resume Examples & Samples

  • Inform appropriate departments of patient arrival
  • Appropriately prioritizes job tasks to meet the needs of internal and external customers
  • Efficiently and accurately utilizes necessary technology to perform job tasks
  • Maintain established hospital and departmental policies and procedures, objectives, safety and environmental standards
  • Contact patients to acquire appropriate pre-registration information
  • Schedules patients in scheduling system
  • Reviews correspondence from carriers to determine why a claim was denied or paid inappropriately, after the appropriate refiling of the corrected claim is made
  • Document, analyze, and correct errors with submission to manager for review
  • Reviews accounts before final bill to determine accuracy of charges and dates
  • Work to ensure a payment plan or financial option is in place before any non-emergency procedure is scheduled
  • Review payment activity on accounts to determine if the balance is owed by the patient or insurance provider
  • Answer questions from patients and insurance providers
  • Document phone calls, the reason for the call and any actions taken
  • Protect the health and financial information for all patients by verifying important data elements before proceeding with caller inquiries
  • Mail itemized statements and fax documentation to insurance companies
  • Mail insurance claims and letters while making the appropriate notes
  • Communicate with patients regarding outside assistance programs, payment arrangements, and financial assistance applications
  • Process letters of approval or denial for assistance programs
  • Reviews accounts for debt placement
  • Perform other responsibilities as needed
  • Work in accordance with corporate and organizational security policies and procedures
  • Understand personal role in safeguarding corporate and client assets
  • Takes appropriate action to prevent and report any compromises of security within scope of role
  • Must be located in or near the Carrollton, Missouri area
  • Demonstrates excellent writing skills, understands medical terminology, and is computer literate (word processing and other relevant software)
  • Has worked in a position where high levels of confidentiality were maintained
29

Patient Access Representative Resume Examples & Samples

  • Previous experience with the medical industry
  • Previous cash handling experience (cashier, sales clerk, server, etc.)
  • Must be willing and able to commit to flexible 24 hour work schedule as needed
  • Patient registration experience in an acute care facility
  • Experience with medical insurance (verification, explaining coverage details)
30

Associate Patient Access Representative Resume Examples & Samples

  • Greets patients and visitors in a prompt, courteous, and helpful manner. (100%)
  • Registers patients, verifies and updates necessary information in the medical record. (100%)
  • Maintains appointment book or appointment scheduler and follows office scheduling policies of the medical group/SWMP. (100%)
  • Answers telephone, screens calls, takes messages and provides clerical information. (65%)
  • Pulls and files charts, coordinates lab work. (40%)
  • Sorts and delivers mail, medical records and other correspondence. (10%)
  • Handling of precertification and referrals. (30%)
  • Performs Trial Daily Close and completes daily banking deposits. (5%)
  • Collecting co-pays and self pays. (100%)
  • Assist in care and maintenance of department equipment and supplies
  • Photocopies records when requested with proper approval
  • Distribution of Patient Satisfaction Survey
  • Attends meetings as required
  • Knowledge of Medical Manager
  • Knowledge of managed care contracts
  • High School degree or equivalent
  • One year minimum experience in a medical office setting to include data entry and clerical
31

Patient Access Representative Resume Examples & Samples

  • Perform full duties and task of an Associate Patient Access Representative
  • Assist patients with the financial assistance process to include screening
  • Sends notifications to insurance companies on inpatient and observation patients and communicates with Case Management if clinicals are required and documents in Meditech notes
  • Confirm all procedures have required authorizations
  • Assist patients with on site customer service functions (e.g., billing, medical records and collection inquires)
  • Act as a knowledgeable resource on Patient Access for department staff. (e.g., answer questions, assist with new hires)
  • Review own work for accuracy and completeness prior to end of shift
  • Adhere to state and federal regulations
  • Meet productivity, point of service collections, and quality goals/standards
  • A minimum of 3 years healthcare experience within Patient Access of Business office setting
  • Previous experience with insurance eligibility systems
  • Utilization of medical terminology in job setting
  • Knowledge in medical billing codes
  • High school diploma or GED preferred
32

Patient Access Representative M-F 11am to 8pm Resume Examples & Samples

  • Minimum typing skills of 35 wpm
  • Demonstrated working knowledge of PC/CRT/printer
  • Knowledge of function and relationships within a hospital environment preferred
  • Customer service skills and experience
  • Ability to work in a fast paced environment
  • Ability to receive and express detailed information through oral and written communications
  • Course in Medical Terminology required
  • Understanding of Third Party Payor requirements preferred
  • Understanding of Compliance standards preferred
  • Must be able to perform essential job duties in at least two Patient Access service areas including ED
  • Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors
  • Builds and maintains collaborative relationships with both internal and external Clients that lead to more effective communication and a higher level of productivity and accuracy
  • Must be able to appropriately interpret physician orders, medical terminology and insurance cards while maintaining Conifer Standards of Care
  • High School Diploma or GED required
  • 0 – 1 year in a Customer Service role
  • 0 – 1 year administrative experience in medical facility, health insurance, or related area preferred
  • Some college coursework is preferred
  • Must be able to sit at computer terminal for extended periods of time
  • Occasionally lift/carry items weighing up to 25 lbs
  • Frequent prolonged standing, sitting, and walking
  • Occasionally push a wheelchair to assist patients with mobility problems
  • Hospital administration
  • Can work in patient care locations which include potential exposure to life-threatening patient conditions
  • Must be available to work hours and days as needed based on departmental/system demands
  • Resolves Physician's office and Patient issues. May experience extreme patient volumes and uncooperative Patients
33

Patient Access Representative Resume Examples & Samples

  • Responsible for the processing of paperwork such as upgrading charts, IM's and delivery of observation packets
  • Must request and collect co-payments/deductibles at the time of registration
  • Maintain and monitor bed board while working & communicating with nursing units
  • Maintain expiration log
  • Navigating electronic health records
  • All other tasks associated with the Patient Access Department as assigned by Manager
34

Patient Access Representative Resume Examples & Samples

  • Performs complex eligibility verification & resolves any discrepancies, identifies need for financial assistance recommendation & application, referring to the Financial Counselor where necessary
  • Verifies Insurance Eligibility & Benefits (include policy limitations) for all payers prior to or upon admission to the hospital, using computer based verification programs, as available
  • Completes registration requirements for professional billing into HealthConnect for patients receiving services at northwest plan hospitals
  • Maintains & completes pre-admission processes for surgical admission in preparation for date of service
  • May schedule and/or cancel right type of appointment based on member's needs & regional protocol
  • One (1) - two (2) years of higher education preferred
35

Patient Access Representative Resume Examples & Samples

  • Performs
  • 1 years of relevant working experience; health insurance experience with
  • Intermediate
  • Excellent
  • Solid
36

Patient Access Representative Resume Examples & Samples

  • Registration: Greets and registers patients for various medical services in the hospital setting potentially in a 24 hour, 7 day a week environment and in a highly active fast paced setting such as the Emergency department. Pre-registers patients where applicable
  • Performs minimal eligibility verification and resolves discrepancies as able or defers to appropriate resource, identifies need for financial assistance recommendation and application, referring to the Financial Counselor where necessary
  • Provides patient liability information and collects the point of service cash from patients based on guidelines and/or systems provided by the department, including but not limited to: co-payments, deductibles, co-insurance, deposits, and outstanding balances
  • Communicate to the patient the Northwest's policy on payment of services or prepayment when significant patient liabilities are identified
  • Makes copies of patient identification, insurance information and other related forms and documents, electronically scan capture where appropriate
  • Escorting patients to area of service
  • Performs all other duties as assigned consistent with job description
  • Obtains training and becomes CPR Certification within 30 days if existing Patient Access Employee or has proof of current CPR Certification, outside applicant must have upon hire
  • Excellent organizational and written skills, flexibility and ability to switch tasks frequently
  • Ability to operate CRT, IBM compatible PC, Windows, such as MS Word/Excel, copier, fax, phone, and headset
  • Working knowledge of basic medical terminology, diagnostic related groupings, diagnosis and common procedure terminology to determine benefits and estimate service cost
  • Knowledge of Medicaid, Medicare, and other government and insurance/payor requirements
  • Knowledge of basic State and Federal regulations governing healthcare encounters, such as HIPAA, State worker's compensation, third party liability for accidents, EMTALA and etc
  • Knowledge of and skill in the use of automated Patient care systems for admissions, registration, and basic medical records functions (registration systems)
  • Knowledge of basic state and federal regulations regarding funding resources
  • Knowledge of organization's and/or facility based billing systems
37

Patient Access Representative 7pm to 7am Resume Examples & Samples

  • Minimum typing skills of 35 wpm
  • Demonstrated working knowledge of PC/CRT/printer
  • Knowledge of function and relationships within a hospital environment preferred
  • Customer service skills and experience
  • Ability to work in a fast paced environment
  • Ability to receive and express detailed information through oral and written communications
  • Course in Medical Terminology preferred
  • Understanding of Third Party Payor requirements preferred
  • Understanding of Compliance standards preferred
  • Must be able to perform essential job duties in at least two Patient Access service areas including ED
  • Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors
  • Builds and maintains collaborative relationships with both internal and external Clients that lead to more effective communication and a higher level of productivity and accuracy
  • Must be able to appropriately interpret physician orders, medical terminology and insurance cards while maintaining Conifer Standards of Care
  • High School Diploma or GED required
  • 0 – 1 year in a Customer Service role
  • 0 – 1 year administrative experience in medical facility, health insurance, or related area preferred
  • Some college coursework is preferred
  • Must be able to sit at computer terminal for extended periods of time
  • Occasionally lift/carry items weighing up to 25 lbs
  • Frequent prolonged standing, sitting, and walking
  • Occasionally push a wheelchair to assist patients with mobility problems
  • Hospital administration
  • Can work in patient care locations which include potential exposure to life-threatening patient conditions
  • Must be available to work hours and days as needed based on departmental/system demands
  • Resolves Physician's office and Patient issues. May experience extreme patient volumes and uncooperative Patients
38

Patient Access Representative With Benefits 12pm to 5pm Resume Examples & Samples

  • Minimum typing skills of 35 wpm
  • Demonstrated working knowledge of PC/CRT/printer
  • Knowledge of function and relationships within a hospital environment preferred
  • Customer service skills and experience
  • Ability to work in a fast paced environment
  • Ability to receive and express detailed information through oral and written communications
  • Course in Medical Terminology preferred
  • Understanding of Third Party Payor requirements preferred
  • Understanding of Compliance standards preferred
  • Must be able to perform essential job duties in at least two Patient Access service areas including ED
  • Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors
  • Builds and maintains collaborative relationships with both internal and external Clients that lead to more effective communication and a higher level of productivity and accuracy
  • Must be able to appropriately interpret physician orders, medical terminology and insurance cards while maintaining Conifer Standards of Care
  • High School Diploma or GED required
  • 0 – 1 year in a Customer Service role
  • 0 – 1 year administrative experience in medical facility, health insurance, or related area preferred
  • Some college coursework is preferred
  • Must be able to sit at computer terminal for extended periods of time
  • Occasionally lift/carry items weighing up to 25 lbs
  • Frequent prolonged standing, sitting, and walking
  • Occasionally push a wheelchair to assist patients with mobility problems
  • Hospital administration
  • Can work in patient care locations which include potential exposure to life-threatening patient conditions
  • Must be available to work hours and days as needed based on departmental/system demands
  • Resolves Physician's office and Patient issues. May experience extreme patient volumes and uncooperative Patients
39

Patient Access Representative Resume Examples & Samples

  • Responsible for collecting and documenting copays and deductibles
  • Responsible for finding and creating charts for Occupational Medicine patients in order to complete the registration process. Also responsible for compiling the appropriate corresponding paperwork
  • Responsible for accurately entering appropriate charges for services rendered
  • Responsible for accurate order entry for Lab, Radiology, and Occupational Medicine
  • Responsible for distribution of Radiology films with appropriate paperwork/request
  • Responsible for notifying Radiology personnel for distribution of barium
  • Monitor and maintain inventory supplies for the reception area
  • Comply with Network and departmental policies regarding attendance and dress code
  • Demonstrate competency in the assessment, range of treatment, knowledge of growth and development and communication appropriate to the age of the patient treated
  • Demonstrate competency with Downtime procedures for the Hospital Information System and Lab Information System
  • Maintain a working knowledge of the policies and procedures pertaining to outpatient registration, order entry, and requests for outpatient services including but not limited to outpatient registration, order entry, and request for services
40

Patient Access Representative Resume Examples & Samples

  • Assists with the assignment of patient beds
  • Accurate registration and/or pre-registration of patients within established departmental guidelines for both socio-demographic and financial/insurance data as back to up daily registration staff
  • Facilities patients’ intake/transition to the health system by providing excellent customer service skills and serving as an advocate for the patient in identifying third party payer coverages and referral and pre-certification requirements. Collecting Co-pay deductibles and cash collection
  • Educating the patient regarding their rights, advance directives, system services, and other patient services
  • Providing timely and accurate information regarding patient data/status to other health system departments, physicians, physician office staffs, and other publics while insuring patient confidentiality is not breached
  • Insuring patient flow through the registration process or phone intake process is professional, patient friendly, and within department established time standards
  • Two years of college or 2 years prior equivalent experience in a health care setting
  • Computer knowledge and minimum typing requirements of 50 wpm
  • Knowledge of health insurance terminology, policies and eligibility are required
  • Knowledge of clinical terms helpful
  • Must have excellent interpersonal skills, communication skills and ability to work with patients, their family and the public
  • Knowledge of Meditech system preferred
41

Patient Access Representative Resume Examples & Samples

  • Knowledge of medical terminology, CPT & ICD-9 (10) codes and all insurance preferred
  • Excellent communication and customer service
  • Previous experience in any Rehab setting preferred
  • Excellent computer skills including Data Entry, Excel and Word
  • Passing score of 80% or higher on Medical Receptionist test required
  • Previous experience with electronic scheduling systems preferred
  • Must be able to prioritize and work in a fast paced environment
42

Patient Access Representative Resume Examples & Samples

  • Utilizes medical acceptance criteria to screen and schedule appointments for new patients, to ensure optimal efficiency in clinic operations
  • Communicates clearly and professionally in all patient communications
  • Revenue Integrity
  • Collects complete and accurate financial and consent data during intake and registration process, and verifies data during new patient registration
  • Obtains insurance information, verifies benefits, and secures authorizations when needed
  • Communicates financial information to patients, including cost estimates, payment plans, discounts, and supplemental financial assistance; providing clarification on medical overrides and account reviews as appropriate
  • Completely and accurately documents communications with payors, patients, and the treatment team, using established guidelines for each area and demonstrating appropriate task prioritization and urgency
43

Patient Access Representative Resume Examples & Samples

  • Simultaneously collect information from patients and key data in EPIC
  • Schedule appointments, procedures, and events at our NorthShore locations
  • Register and verify insurance eligibility, informing the patients of their financial responsibility
  • One year of customer service experience; healthcare or call center experience preferred
  • Basic computer skills including proficiencies in Microsoft Windows, Excel, and Outlook, as well as the ability to type 25 words per minute
  • Exhibits essential Customer Service focused commitment demonstrating active listening, focus on issue resolution, sharp attention to detail, and analytical and problem solving abilities to meet and exceed the needs of our patients
  • Demonstrates importance of attendance and maintaining a positive work environment, arriving on time and with minimal absenteeism
  • Eager to accept educational opportunities as shared through workflow or process changes
44

Patient Access Representative Day Shift Resume Examples & Samples

  • Verifies all insurance/self pay through online eligibility. When online eligibility is not available for the insurance, responsible for contacting insurance companies to verify benefits via phone or insurance website
  • Responsible for identifying, collecting, and recording self pay, or co pay and/or deductibles when applicable prior to or at time of registration
  • Online posting of credit card payments
  • Provide other hospital departments and physician offices with information or materials related to Network Registration processes
45

Patient Access Representative Resume Examples & Samples

  • Interview and pre-register patients at the time of or prior to the visit date
  • Input patient information into the computer to initiate a medical record and a bill
  • Confirm/Verify insurance benefits with the appropriate carrier via on-line verification systems or telephone inquiries
  • Schedule patient appointments in accordance with UPMC and department-specific guidelines
  • Two years of experience in a medical, billing, fiscal or customer service function is preferred
46

Patient Access Representative Resume Examples & Samples

  • Answers telephones; takes and relays messages; greets and directs patients and visitors
  • Handles routine requests for information from other departments
  • Completes the registration process, obtaining accurate patient demographic and financial information
  • When applicable, utilizes the EVS, Blue Cross and/or Medicare by use of the Internet to verify insurance coverage
  • Coordinate after hour appointments based on Business Unit requirements; provide call center support and ensure accuracy of all on call schedules for each office and program
  • Demonstrate competence in understanding all of the Agency's service lines to ensure accurate information is shared with potential customers and referral sources
  • Demonstrate knowledge of insurance and managed care requirements. Notifies Authorization and Verification Assistant for necessary clinical follow-up with insurance
  • Maintains and replenishes all office supplies and equipment
  • Obtain and update demographic, emergency contact and insurance information, including referrals/authorizations on all patients as needed
  • Support and contribute to UPMC core values and guiding principles of Your Care
  • Our Commitment and abide by all UPMC departmental policies, procedures and goals in the process of performing all job responsibilities. Incorporates acts of dignity and respect in daily interactions
  • Completion of a medical office, medical terminology or insurance billing course preferred
  • Two years of experience in a position requiring direct public contact and an understanding of third party insurances preferred
  • Working knowledge of medical terminology preferred
  • Excellent interpersonal, written, and communication skills required
  • Able to work well under pressure Initiative to work productively with minimal supervision
47

Patient Access Representative Resume Examples & Samples

  • Verbalize knowledge of, and participate in, emergency management exercises
  • Accurately perform and document patient care services
  • Perform business office functions (clerical, environmental, and organizational) under the supervision of the Practice Manager or Supervisor
48

Patient Access Representative Resume Examples & Samples

  • Access the proper Epic application and accurately enters information necessary to begin / complete the registration process
  • Responsible for accurate transcribe outpatient orders
  • Demonstrate efficiency and familiarity with all Epic application responsible to complete functions of the position
49

Patient Access Representative Resume Examples & Samples

  • Obtains demographic, insurance and financial information from patient or guarantor
  • Enters information in computer system with a high degree of accuracy
  • Explains all required forms to the patient or guarantor and obtains the necessary signatures. Ensures medical necessity compliance by obtaining necessary data, reviewing Compliance System, communicating information to patient or guarantor and obtaining necessary signatures
  • Verifies insurance eligibility and benefits and ensures all notifications and authorizations are completed within the required time frames
  • Posts payments in the computer system and generates the appropriate patient receipts. Monitors, reviews and resolves patient account issues on assigned reports
  • Communicates in an effective and professional manner with Physicians, ancillary departments, nursing units, physicians’ office staff, insurance companies, as well as patients and their families (all Patient Access customers)
  • Completes thorough and accurate documentation
50

Patient Access Representative Resume Examples & Samples

  • Three (3) years of experience in a hospital or medical business office setting
  • Protects the financial integrity of the facility by collecting patient liability, establishing payment arrangements, discussing payment options and screening for eligibility. Completes complex financial counseling including the review and submission of charity applications. Identifies alternative resources for financial reimbursement
  • Monitors, reviews and resolves patient account issues on assigned reports. Performs account analysis and trending
  • Functions as a team leader in the department by ensuring daily processes are complete, scheduling employees, providing answers to employee questions and assisting in employee orientation and training
  • Communicates in an effective and professional manner with Physicians, Care Management, ancillary departments, nursing units, physicians’ office staff, insurance companies, as well as patients and their families (all Patient Access customers). Completes thorough and accurate documentation
51

Patient Access Representative Resume Examples & Samples

  • All out of pocket financial responsibility is requested prior to and/or at the time of service
  • Refers patients for financial assistance or to the Medicaid Eligibility team when appropriate
  • Accurately posts patient payments and balances cash drawer as per departmental policy
  • Obtains legal signatures on appropriate insurance, consent, and financial forms
  • Obtains all required clinical information including paper requisitions as needed
  • Knowledgeable of computer down time procedures, notifying all parties involved, and utilizing manual processes as appropriate
  • Participates in professional continuing education opportunities
  • Volunteers readily, actively seeks new knowledge and skills for personal and job development
  • Takes responsibility for own actions and commits to doing the best job possible
  • Meets established patient processing goals and revenue cycle goals
52

Patient Access Representative Resume Examples & Samples

  • Mercy Service -
  • Greets every individual on the phone or in person with a smile and a warm, professional greeting
  • Provides outstanding customer service to all internal and external customers including our patients, visitors, co-workers, physicians, and insurance companies
  • Keeps all wait times to a minimum
  • Communication -
  • Works effectively with other co-workers, clinical departments and clinics to accomplish work and departmental projects
  • Demonstrates positive and professional communication skills
  • Exhibits objectivity and openness to others’ views, contributes to building a positive team spirit
  • Confidentiality -
  • Respects at all times the confidentiality of patient records and uses complete discretion when discussing patient matters
  • Ensures all patient information is secured and all paperwork is disposed of in appropriate confidential trash receptacles
  • Stewardship -
  • Ensures all out of pocket financial responsibility is documented on all encounters and communicated as appropriate
  • Change Management -
  • Demonstrates an open attitude toward change and participates in the change process
  • Handles variance in job duties, making necessary adaptations
  • Follows instructions, responds to management direction
  • Quality -
  • Ensures the highest level of accuracy and thoroughness of registration information including demographics and insurance information
  • Accurately identifies patient record using a minimum of two patient identifiers (name, DOB, SSN)
  • Ensures that appointments are scheduled accurately and all required directions are communicated to the patient
  • Referrals are accurately completed including all required smart phrases
  • Follows all policies and procedures pertaining to insurance verification, eligibility, appropriate pre-certification requirements
  • Compliance -
  • Obtains all required data to meet various Health System standards and regulatory requirements (e.g. Joint Commission, Medicare Compliance, EMTALA, HIPAA, etc.)
  • Proficiency and Initiative -
  • Demonstrates knowledge of the necessary computer applications
  • Qualification 1: High School diploma required some college helpful
  • Qualification 2: 1-3 years clerical experience preferred. Experience with medical terminology and insurance plans preferred
53

Patient Access Representative Resume Examples & Samples

  • Performs receptionist type duties as assigned
  • Performs cashier duties as appropriate
  • Performs scanning duties where appropriate. With 100% accuracy, loose documentation and other miscellaneous needs are scanned into the patients electronic charts within 24 hours
  • Manages medical records as needed
  • Participates in organizational professional activities
  • Demonstrates knowledge of special needs and behaviors of specific age groups
  • Follows appropriate Mercy Physicians of Oklahoma (MPO) policies
  • Assists in other areas of the clinic and within the Mercy Physicians of Oklahoma where requested
  • Education: High School Education
  • Experience: Skills in office operation and medical terminology. Organizational skills a must
  • Other:Ability to establish and maintain positive working relationships with patients, physicians, clinical and non-clinical hospital staff and insurance companies.Ability to communicate effectively both orally and in writing, excellent telephone etiquette required.Strong organizational skills; attention to detail. Ability to work under stress, meet deadlines and perform all daily assignments with a high level of accuracy. Knowledgeable and experienced with various computers systems; Ability to use a 10-key calculator and computer keyboard
  • Preferred Experience: 1-3 yrs. of clinical/medical office experience
54

Patient Access Representative Resume Examples & Samples

  • Ability to establish and mainatin positive working relationships with patients, physicians, clinical and non-clinical hospital staff and insurance companies
  • Strong organization skills; attention to detail
  • Knowledgeable and experience with various computer systems; Ability to use a 10-key calculator and computer keyboard
55

Patient Access Representative Resume Examples & Samples

  • Ensures accounts requiring authorizations and
  • 2-3 years of relevant working experience to
  • Demonstrated ability to handle challenging
56

Patient Access Representative Resume Examples & Samples

  • Establishes patient record for registration or pre-registration by obtaining necessary clinical, demographic, financial and insurance information, accurately entering information into the electronic registration system
  • Complies with all regulatory requirements, accreditation standards, hospital policies and procedures in performance of patient registration
  • Processes physician office fax forms
  • Utilizes variable software and online verification systems for screening and authorization/referral purposes
  • Collects and processes patient co-pays and payments, and balances cash drawer
  • Performs switchboard operator and clerical duties as assigned which may include routing phone call, facility paging, initiating codes and monitoring alarm systems
  • Performs clerical duties related to admission, transfer and discharge and maintenance of patient activities for the record, telephone answering and unit receptionist
  • Transcribes orders subject to the approval of a licensed nurse requesting clarification when necessary
  • Communicates with patients, families, physicians and other healthcare team members regarding patient care and other issues
  • Required experience in at least one of the following: registration, switchboard, customer service, cashiering or receptionist
  • Required to be computer literate including keyboarding
  • Must be able to work in a dynamic environment and take appropriate actions
  • Associate degree or diploma for Medical Billing Program preferred
  • Preferred experience in spreadsheet and word processing programs
  • Medical coding and medical terminology experience preferred
57

Patient Access Representative Resume Examples & Samples

  • Document pertinent patient information and all account work activity in the appropriate systems dictated by the health care facility and Company
  • Responsible for capturing and documenting all pertinent patient demographic, subscriber, and insurance information (i.e.): patient Policy and ID numbers, subscriber, guarantor, payer address, phone numbers, and other contact information. Documentation must include, benefit effective date, copay, deductible, out of pocket non-covered services responsibilities, co-insurance, stop loss amounts, percentage of coverage and any other pertinent information concerning the specific procedure/clinical service to be performed
  • Responsible for securing authorizations and documenting all pertinent information (i.e.): Insurance, Ordering information, Physician information, Tax ID, CPT, HCPCS and ICD 10 codes. Documentation must include, authorization status, authorization number, ordering procedures, verified from, dates approved for and any other pertinent information
  • Personally responsible, respect for self and others, innovative through teamwork, dedication to caring and excellence in customer service
  • Obtains and accurately completes ABN or MSP forms, when applicable
  • Obtains complete and accurate insurance information and completes insurance verification by contacting patients, physician offices and insurance/payer regarding the visit
  • Responsible for communicating with patients regarding patient financial responsibilities before or at time of service. Informs patients on billing process for facility and providers
  • Responsible for understanding and complying with all policies, procedures, and regulations relating to job duties
  • 1 year experience in Patient Access, Patient Financial Services, or previous experience in a hospital or physician’s office required. 2-3 years related experience preferred
  • Must be able to multitask, coordinating more than one event at a time
  • Must be able to demonstrate knowledge of hospital billing requirements and the documentation necessary to satisfy those requirements
  • Experience/knowledge of: medical terminology, data entry, computer skills, admitting, business office, cash collections, physician office interactions and working with public preferred
  • Customer Service/Patient Relations – displaying professionalism
  • Must possess detailed understanding and knowledge of insurance guidelines and protocols, components of full verification, and payer information / requirements
58

Patient Access Representative Resume Examples & Samples

  • Additional responsibilities include interviewing patients/guarantors to obtain demographic and confidential clinical and financial information necessary to appropriately schedule, register, obtain treatment authorizations and verify insurance eligibility and corresponding benefit levels
  • All information is entered into the Hospital's computer system to expedite data collection, billing and Hospital reimbursement
  • Critical to this position is the ability to gather and record all appropriate information that lays the groundwork for the remaining or future fiscal efforts of the Hospital
59

Patient Access Representative Hrs Resume Examples & Samples

  • Requires at least two years of previous experience in registration, medical office work or managed care; one year of registration experience is preferred
  • Computer skills are essential-including Microsoft Office and Internet
  • Requires the ability to maintain patient confidentiality
  • Customer service experience is essential
  • Requires the ability to maintain flexibility
60

Patient Access Representative Resume Examples & Samples

  • Education:High school diploma or GED required
  • Experience:2 years Patient Access/Medical Office experience required
  • Skills:Excellent customer service, organizational, communication, intrapersonal, and problem solving skills
  • Skills Testing:Basic Typing Test
61

Patient Access Representative Resume Examples & Samples

  • Health care or insurance experience with a minimum of 1-year ambulatory practice experience
  • Comprehensive working knowledge of third party insurance processes
  • Prior experience in liaison role for providers and staff
  • Demonstrated proficiency with PC-based computer skills
  • Completion of PMC’s the Medical Terminology Test for BOS/PSR/PAR Staff with a passing score within 90 days of hire
  • One year experience with coding: ICD-9, CPT, HCPCS
  • One-year patient third party eligibility verification experience on an automated patient accounts system
62

Patient Access Representative Resume Examples & Samples

  • 1 Interviews the patient / family for admission and outpatient registration by entering the appropriate required information on-line. This will include, but is not limited to: demographics, clinical, and detailed insurance information
  • 2 Greets patients and visitors both in person and via telephone using the concepts of Personal.Connected.Journey, focused on creating a unique service-focused experience for each engaging with the practice
  • 3 Independently schedules procedures for all departments and any subsequent departments added to Enterprise Scheduling, HealthQuest and various patient information systems, utilizing individual departmental grids, resources and guidelines
  • 4 Determines if authorization is required for the patient's service and secures authorization for treatment/procedures prior to service being rendered
  • 5 Determines an understanding of hospital policies, prevailing regulatory and third party requirements (MSP questionnaire, pre-certification process, consent forms, etc.)
  • 6 Recognizes and problem solves conflicts associated with time requests, resources, equipment or staff for each department
  • 7 Coordinates multiple hospital services such as surgical procedures, ancillary testing, etc., in proper sequence and according to the rules of the system, which may include managed care requirements and clinical standards
  • 8 When appropriate, problem-solves with the patient regarding scheduling, billing and other insurance related concerns
  • 9 Maintain uninterrupted scheduling service utilizing down-time procedures
  • 10 Provides daily reports or printouts as directed while maintaining the confidentiality of patient records and information at all times
  • 11 May perform clerical tasks specific to supporting an assigned department(s) i.e., receptionist duties, charge capture, report processing and delivering, copying, filing, etc
  • 12 Ability to collect point of service co-payments for insured patients when identified for scheduled services as well as point if service collections for uninsured patients
  • 13 Attends and participates in meetings to improve the service environment and customer improvement
  • 14 Performs other duties as assigned
63

Patient Access Representative Resume Examples & Samples

  • Assures secure handling and accurate recording of payments collected at the point-of-service delivery
  • Builds a foundational understanding of the different health insurance coverage options and the related processes and procedures
  • Escalates any advanced or complex registrations to a more experienced team member
  • Greets patients and begins the registration process
  • Performs other duties and responsibilities as assigned by the unit team manager or other PAS management personnel
  • Provides excellent customer service to all individuals with whom the employee has contact
  • Responsible for Cash Collection protocols
  • The specific job duties will be comprised of a combination of responsibilities from among the various areas of PAS operations including: On-site, Ancillary, Financial Counselor, Access Unit, and Emergence Department Registration
64

Ancillary Patient Access Representative Resume Examples & Samples

  • Minimum of High School Diploma/GED is required
  • 1-2 years previous experience in a customer service role required. Healthcare setting is preferred. Experience may be offset with completion of an Associate’s degree or equivalent education, or successful completion of an approved medical assistant program accredited by the Accrediting Bureau of Health Education Schools (ABHES), or the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Commission of Career Schools and Colleges (ACCSC)
  • Exceptional interpersonal skills, including the ability to establish and maintain effective relationships with patients, physicians, management, staff, and other customers
  • Must be able to maintain strict confidentiality of all personal/health sensitive information
  • Ability to effectively handle challenging situations and to balance multiple priorities
  • Able to communicate effectively in writing
  • Basic computer proficiency inclusive of ability to access, enter and interpret computerized data/information
65

Patient Access Representative Resume Examples & Samples

  • One (1) year registration or clerical experience in a hospital, physician’s office, ambulatory care service or similar health care setting preferred OR one (1) year customer service
  • Excellent verbal communication skills required
  • Must be computer literate in Data Entry Processing
  • Basic knowledge of MS Office Word / Excel preferred
  • Demonstrated ability to perform simple math calculations; ability to accurately handle cash transactions required
  • Demonstrated knowledge of medical terminology required; knowledge of ICD-9/10 / CPT codes preferred
  • Ability to read, write and communicate in English required
66

Patient Access Representative Resume Examples & Samples

  • Interview patient and/or patient representative to obtain required information necessary to complete the registration process in the hospital information system and maintains the accuracy, confidentiality and integrity of the automated database
  • Coordinate and communicate accurate and updated registration/admission/and pre-admission activities with Medical Records, Care/Case Management, Utilization Management, Physicians' offices, Patient accounts, and any other hospital departments, as may be required, to support the appropriate, accurate, safe and effective patient care
  • Initiate and maintain organized files and records, related to orders, payer authorizations, booking slips, schedules, and others per department procedure
  • Contacts patients, employers, insurers and patient representatives to obtain insurance and other information necessary to secure hospital reimbursement, verifies benefits and pre-certifies all insurance plans to ensure maximum reimbursement to the hospital
  • Verifies benefits, utilizing insurance verification systems. Obtains referrals and authorizations required and documents complete information, along with approved bed status, if applicable, in the computer system. Obtains pre-certifications in a manner to ensure maximum allowable reimbursement to the hospital
  • Maintains a thorough knowledge of departmental policies and procedures to ensure maximum reimbursement to the hospital
  • Attends departmental and other meetings as requested by the immediate supervisor
  • Ensure timely placement of patients in the most effective and appropriate manner. Process admissions, discharges and transfers of all Hospital patients, per department procedures
  • Explain and process payments from patients, which may include but not limited to co-pays, co-insurance, and deductibles
  • Follows department procedures related to securing payment information and providing patient receipts
  • Provide information to patient and/or representative on: Health Care Proxy, Advanced Beneficiary Notice, Important Medicare Message (IMM) forms, Financial issues and refers to Financial Counselor if appropriate. Obtain completed forms as available
  • Perform other work related duties and activities as assigned or requested by manager/supervisor
  • Ability to read, write and communicate in English at the level of a high school graduate
  • Ability to type at the rate of 30 WPM as demonstrated by a timed test
  • Computer skills to perform the job functions in a satisfactory, accurate and productive manner
  • Successful passage of a Medical Terminology course or successful passage of Medical Terminology challenge exam
67

Patient Access Representative With Benefits Days & Evenings Resume Examples & Samples

  • Minimum typing skills of 35 wpm
  • Demonstrated working knowledge of PC/CRT/printer
  • Knowledge of function and relationships within a hospital environment preferred
  • Customer service skills and experience
  • Ability to work in a fast paced environment
  • Ability to receive and express detailed information through oral and written communications
  • Course in Medical Terminology preferred
  • Understanding of Third Party Payor requirements preferred
  • Understanding of Compliance standards preferred
  • Must be able to perform essential job duties in at least two Patient Access service areas including ED
  • Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors
  • Builds and maintains collaborative relationships with both internal and external Clients that lead to more effective communication and a higher level of productivity and accuracy
  • Must be able to appropriately interpret physician orders, medical terminology and insurance cards while maintaining Conifer Standards of Care
  • High School Diploma or GED required
  • 0 – 1 year in a Customer Service role
  • 0 – 1 year administrative experience in medical facility, health insurance, or related area preferred
  • Some college coursework is preferred
  • Must be able to sit at computer terminal for extended periods of time
  • Occasionally lift/carry items weighing up to 25 lbs
  • Frequent prolonged standing, sitting, and walking
  • Occasionally push a wheelchair to assist patients with mobility problems
  • Hospital administration
  • Can work in patient care locations which include potential exposure to life-threatening patient conditions
  • Must be available to work hours and days as needed based on departmental/system demands
  • Resolves Physician's office and Patient issues. May experience extreme patient volumes and uncooperative Patients
68

Patient Access Representative Resume Examples & Samples

  • Required to work a few Saturday's a month
  • Greets and directs patients and visitors for the facility to provide friendly and courteous services at all times
  • Enters information in computer system in an accurate manner
  • Answers departmental telephones as necessary
  • Protects the financial integrity of the facility by collecting patient liability and completing documentation
  • Documentation of payments in the computer system and generates the appropriate patient receipts
  • Communicates in an effective and professional manner with patients and their families, Physicians, ancillary departments, physicians’ office staff (allPatient Access customers)
  • Promptly resolve minor issues and inform manager, other department manager or Director of any significant patient and visitor complaint
  • Maintain a working knowledge of policies and procedures pertaining to
  • Adheres to all TOPS Surgical Specialty Hospital policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity, and accuracy of practice
  • Provide assistance to coworkers during peak times and covers for vacation, holiday and sick time
  • Comply with USPI and TOPS Surgical Specialty Hospital policies regarding attendance and dress code
  • Prior experience in a business office or customer service setting
  • Demonstrates commitment to the EDGE process by integrating both Behaviors and Operating Principles in all internal and external customer interactions. Performs duties with accountability, competency, innovation, collaboration, compassion and respect to create the best possible outcomes with exceptional customer experiences
69

Patient Access Representative Resume Examples & Samples

  • Demonstrate efficiency and familiarity with hospital systems including Pathways, Lab, PHS scheduler, Star, Patient Management System, Precision, Patient Tracking Board, Navinet, PIM, and Microsoft Word
  • Demonstrate familiarity and competency with the TTY and ATT Language Lines for patients with hearing impairment/deafness
  • Maintain confidentiality of all patient information
  • Demonstrate and models the hospital’s core values and customer service behaviors in interactions with all customers (internal and external)
  • Comply with hospital and departmental policies regarding safety, attendance, and dress code
70

Patient Access Representative Resume Examples & Samples

  • Responsible for accepting reservations for hospital service; obtains information to pre-register patients. Verifies insurance eligibility
  • Responsible for interviewing patients or their representative, obtaining personal information or verifying information already on file, including emergency numbers, next of kin, employer and insurance information. Is aware of when a patient may feel uncomfortable in the present setting and offer to provide a more private space to perform the registration function
  • Accepts payments for pharmacy items and patient co-payments
  • Accurately records all transactions using a receipt system
  • 0-1 years related work experience required
  • Customer Service:Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations
71

Patient Access Representative Resume Examples & Samples

  • Performs accurate and complete Registration/Preregistrations and & Admissions to provide information which will maximize reimbursement, achieve collection rations and meet Account Receivable goals and provide timely and thorough information to all other providers & customers that utilize the patient data
  • Interview patients face-to-face or by phone to obtain registration information (prior to service/point of service)
  • Obtain interpretive services to provide communications for hearing impaired or when there is a language barrier preventing completion of the registration process
  • Ensures that financial protocols and requirements are met while providing caring access to service at Dimensions Healthcare System
  • Contact insurance companies for patient benefits and authorization approval for patient care
  • Completes departmental intake forms and shift/day end reports fully and accurately
  • Minimizes 3rd party payer denials by verifying authorization of service prior to forwarding patients to service delivery areas
  • Obtains patient signatures on Consent forms, HIPAA, Observation Notice, Insurance Waiver, Important Message from Medicare and other important forms as required within the Hospital’s policies
  • Performs departmental administrative functions as required. Answers all incoming telephone calls according to departmental telephone standards
  • Document on line admission or other patient service dates to initiate payer and hospital utilization review process
  • When necessary, pursue actual approval and authorization number from the insurance based upon diagnosis, service and contract coverage
  • Maintains current knowledge of insurance requirements and an understanding of the changing demands of federal regulations and organizational requirements, DHS/PAS policies and procedures, Joint Commission, state and local mandates communicated by email, memorandum, educational matrices and in-services
  • Work with insurance team specialist to maintain patient flow while resolving financial issues
  • Communicates effectively with service areas when unresolved financial issues threaten appointment schedules and request from physicians that service be rescheduled when payment from insurance or patient is doubtful
  • Negotiates deposits and payment arrangements with patients and or guarantors and attempt to collect patient deposits or other uninsured balances on accounts
  • Conducts Bed Assignment duties accurately and timely
  • Contacts physician offices for orders for patient care
  • Communicates with Nursing, and Environmental Services regarding bed placements and discharges for inpatients
  • Ensures that all required documents are scanned into the correct individual patient record
  • Performance of any requested assignments, tasks or duties within the Patient Access department and as required within the scope of the job description
  • Rotate to various patient access department registration portals as needed
  • Minimum one year related work experience
  • Must be able to type 25 WPM and pass clerical exam
  • Ability to speak read and write in English fluently
  • Must have strong verbal and written communication skills
  • Ability to adapt to technical upgrades and changes throughout the hospital system
  • Ability to work independently, and take initiative in executing work task
  • Ability to work cooperatively with all types of personalities inside and outside the organization
  • Readily accepts responsibilities for one’s own actions and behaviors
  • Serves as an effective resource and acts as a member of the team in a supportive manner. Shows willingness to offer or request assistance when needed
  • Good interpersonal skills with ability to work and communicate (verbally and written) with all levelsof hospital personnel, including physicians, clinicians, and all customers
  • Continuous training to upgrade skill set to support transformation and sustainability
72

Patient Access Representative Resume Examples & Samples

  • 1 to 3 years experience in customer service, data entry, and 1 year of related medical office experience
  • Medical terminology, experience in collections, scheduling and registration preferred
  • Knowledge of medical insurance is preferred
  • Skilled in entering data and calculating items for processing; input of data into computer systems
  • Familiar with medical terminology and medical spelling
  • Effective management of projects, deadlines, and work load prioritizing; putting things together in an orderly and functional whole
73

Patient Access Representative Resume Examples & Samples

  • Collects and enters all necessary demographic, clinical, billing and insurance information from patients or responsible parties
  • Explains processes and forms to patients prior to securing signatures and ensures that all documents are properly signed and witnessed as required
  • Preferred Qualification: Experience providing telephone customer service. Experience working in patient access in an acute hospital setting. Experience working with patient medical billing and/or insurance
74

Patient Access Representative Resume Examples & Samples

  • Ability to work with all types of patients
  • Excellent verbal and written communication including professional one-on-one interactions and phone skills
  • Proficient in data entry with multiple software application usage
  • Resourceful out-of-the box thinker, ensuring timely resolution of patient needs
  • Maintains professional demeanor in every level of communications whether inter-department, customer, peer, or leadership
75

Patient Access Representative Resume Examples & Samples

  • Excellent phone communication skills; Bilingual a plus
  • Strong listening and communication skills
  • Willing to work to resolve customer need despite limitations in resource available
  • Answer, triage and process requests for new patient appointments with primary and specialty providers in a timely manner, making sure that all appointments are made with respect to patient preferences, & insurance plan (where appropriate)
  • Responsible to efficiently expedite the highest number of requests without compromising an exceptional customer experience
  • Promotes cooperation and helpful behaviors towards all. Shares ideas and participates in performance improvement related activities
  • Maintains professional demeanor in every level of communication whether inter-department, customer, peer, or leadership
76

Patient Access Representative Resume Examples & Samples

  • Position requires cross training in the department which includes staffing the reading room assisting the radiologists
  • Reading Room duties include but are not limited to: screen calls, multi-task, answer busy phones, respond to radiologist requests, burn CD’s, push images via Powershare, obtain prior studies, and other busy tasks. Read results and have good pronunciation of terms
  • Critical thinking and troubleshooting skills highly preferred
77

Patient Access Representative Resume Examples & Samples

  • May negotiate pricing for non-contracted payers and authorize patient services and ensure proper pricing is indicated in RxHome. Handle Escalations
  • Use discretion & independent judgement in handling pt or more complex client complaints, escalating as appropriate
  • 3-5 years of relevant working experience
  • Health care experience with medical insurance knowledge and terminology and experience in patient access preferred
78

Patient Access Representative Resume Examples & Samples

  • Must be able to type 35 wpm and pass clerical exam
  • Must have thorough insurance knowledge and be knowledgeable with regards to acess services
  • Must possess skill to obtain benefits, precertification, preauthorization and have collection experience
  • Previous experience in hospital admissions, business office and or physicians office preferred
79

Patient Access Representative Resume Examples & Samples

  • Secures patient account by obtaining appropriate demographic, insurance, verifying eligibility of insurance using eligibility tools, and obtaining patient medical information
  • Strives to minimize patient arrival to treatment area time, improving customer satisfaction as it relates to the registration process, waiting time and general communications
  • Experience with accurately scheduling patients for future appointments as well as follow up post discharge
  • Works closely with ancillary departments to ensure the overall patient experience meets and/or exceeds organizational goals
  • Supports management team members and performs all duties in a manner which promotes team concept and reflects the mission and philosophy of Shriners Hospitals for Children
80

Patient Access Representative Resume Examples & Samples

  • Medical front office experience
  • High school/GED
  • Experience in oncology office
  • Medical insurance billing experience; ICD-10 coding
81

Patient Access Representative Resume Examples & Samples

  • Highschool/GED
  • Insurance billing experience
  • Admitting experience
82

Patient Access Representative Resume Examples & Samples

  • Coordinates all diagnostic and ancillary scheduling; schedules appointments, selecting appropriate referral, provider, visit type and location to expedite patient access to care, minimize no shows and maximize reimbursement
  • Ensures referrals, pre-authorizations, pre-certifications have been accurately obtained as required by the patient's payer
  • Explains and secures consent for all registration forms, including consent forms, HIPAA Privacy Rules, MyChart enrollment, Patient Rights and Responsibilities, etc
  • Greets and directs patients and visitors; provides information regarding services and provides additional assistance when required
  • Identifies existing Medical Record Number (MRN) or creates new MRN, taking care to avoid duplicates and overlays in accordance with National Patient Safety Goals
  • Interviews and registers patients, by phone or in person in a respectful, professional, accurate and efficient manner, obtaining all necessary demographic, financial and clinical information required to facilitate timely registration and billing
  • Maintains productivity levels, with minimal errors, as established by department and Network standards
  • Performs end-of-shift and/or end-of-day reconciliation procedures (i.e. diagnosis and/or charge code entry, reporting, cash balancing)
  • Performs sign-in and check-in functions to expedite patient flow
  • Reviews and confirms patients financial information, informs patients of financial obligations, assesses need for financial assistance and refers to financial screening if needed
  • Verifies benefits, calculates and collects copays, deductibles, clinic fees or deposits, and accurately balances cash drawer
  • 1 plus year of experience using Microsoft Professional Office Suite including, Word, Excel and Outlook
  • Completion of 90 day and annual competency based registration knowledge and skills assessments
83

Patient Access Representative Resume Examples & Samples

  • Serves as the first point of contact and manages the flow of patients and visitors
  • Ensures that all patients are received in a timely manner; keeps management apprised of extended patient wait times and contributes to the resolution of service delays
  • Interviews all patients, family members, and/or patient representatives during the registration process
  • Collects patient information including, demographic, insurance, emergency contact and physician information. Enters information into the hospital information system and assembles patient chart including patient identification bands and labels. Ensures patient identification band is placed on patient
  • Confirms patient’s insurance coverage eligibility and plan requirements utilizing the electronic verification system and / or insurance company websites. Communicates with physician offices and ancillary departments as necessary to determine eligibility. Updates hospital information system with appropriate insurance plan codes
  • Verifies patient’s co-payments and deductible responsibilities and ensures collection. Provides treatment estimates and approximate balances from patients prior to service and documents all interactions into the patients account
  • Obtains necessary signatures on consent forms, in compliance with state and federal regulations and assists patients in completing required documentation
  • Provides patients with insurance waivers, Advanced Beneficiary Notice (ABN) and exclusion forms when insurance cannot be verified or services are not covered
  • Screens all Medicare laboratory exams for medical necessity utilizing the medical necessity software
  • Coordinates timely bed placement for all inpatient, transfers and outpatient bed requests. Communicates with physicians and nurses regarding bed availability pertaining to emergency and direct admissions, treatment plan and admission criteria. Maintains bed availability list and accepts reservations for rooms
  • Assigns beds / unit according to the medical needs of the patient, census count and type of accommodations available; collaborates with Nursing Services to facilitate patient placement. Works collaboratively with Bed Officer in tight bed situations
  • Acts as the liaison with the medical examiner and physicians in cases of deceased patients; assists families of deceased patients as appropriate; arranges with funeral director for timely release of remains; ensures physicians complete death certificates in an accurate and timely manner
  • Provides patients with information and responds to inquiries regarding available services, visiting hours and hospital regulations, demonstrating sensitivity at all times
  • Directs patients to correct locations and arranges escort/transport services for patients to appropriate departments as needed
  • Records and maintains department statistics and logs where necessary, including, but not limited to census reconciliation and cash control logs
  • Provides coverage for the Emergency Department, Lab Registration, Medical Services Buildings, Information Desk and Croton registration when needed
  • Completes all educational courses assigned for professional development
  • Provides guidance, training and support to volunteers assigned to the Information Desk
  • Follows Hospital guidelines and departmental outline when identifying confidential patients or patients opting out of the Hospital directory
  • Provides clerical and telephone support, replenishes offices supplies and calls for equipment service repairs
  • Provides coverage in registration areas
84

Patient Access Representative Resume Examples & Samples

  • Acts as an Epic Super User and a Customer Service Champion
  • Coordinates with study Coordinators coordinates to accession study blood draws and/or deliver communication on where and when samples are ready
  • Handles advanced patient accounting and patient admitting issues and projects
  • Handles special projects including assisting the department with financial clearance reporting, and testing for validation of end under functionality of applications
  • Performs difficult admitting duties including Rooming and planning
  • Performs Lab Intake which includes Laboratory blood draw check in and accessioning
  • Performs Radiology intake which includes accessing RIS database to verify and/or release orders, schedule, and track appointments
  • Provides excellent customer service to all individuals with whom the employee has contact
  • The specific job duties will be comprised of a combination of responsibilities from among the various areas of PAS operations including: On-site, Ancillary, Financial Counselor, Access Unit, and Emergence Department Registration
  • Ability to analyze operational and procedural problems and develop, recommend and evaluate proposed solutions
  • Ability to work well with individuals at all levels of the organization
  • Knowledge of Medicare, Medi-Cal, Workers Comp, Managed Care (HMO, PPO, POS, etc.), Children's Health Programs (CCS, GHPP, Healthy Families, etc.)
85

Patient Access Representative Resume Examples & Samples

  • Accurately and completely register and admit patients having services, treatment or procedures in the healthcare system
  • Collecting patient financial responsibilities and provide receipts to patients
  • Maintain acceptable quality assurance rate during monthly quality assurance reviews
  • Complete all hospital and departmental annual or quarterly training requirements timely
  • Provide service excellence during every patient encounter or when providing internal customer service
  • High School Education, Bachelor’s Degree preferred
  • CPAR preferred
  • Good PC software skills
86

Patient Access Representative Resume Examples & Samples

  • Answers phones in a professional manner. Communicate courteously and effectively with customers and staff. Directs calls to appropriate area and/or taking messages. Answer inquires of a general nature, relaying messages as necessary. (100%)
  • Courteously and effectively facilitates the enrollment of new patients into Cardiac Rehab. Communicates with all parties involved. Processes the enrollment of new patients in a timely manner.(100%)
  • Calls to discover insurance coverage for persons desiring that information prior to enrollment into Cardiac Rehab. Communicates insurance information effectively to patient or family and staff. (100%)
  • Requests, receives, and processes referrals into Cardiac Rehab. Communicates receipt of referral to Cardiac Rehab staff. Obtains referral or order prior to the patient’s first exercise day. Maintains organized records to track this process. Processes referrals in a timely manner. (100%)
  • Efficiently and accurately orders and processes medical records. Maintains organized records to this process. Creates new patient charts. Maintains an organized medical record filing system. (100%)
  • Maintains an organized calendar of new patient appointments. Communicates appointments effectively verbally and in writing with LifeStyle Center staff. (100%)
  • Prioritizes work and promotes prompt and efficient services while maintaining the essential and routine requirements of Cardiac Rehab patients. (100%)
  • Maintains a positive, committed, and cooperative attitude. (100%)
  • Maintains positive interpersonal relations with staff, patients and other customers/guest of the LifeStyle Center. Promotes teamwork and harmony by courteously and readily assisting others in all areas of the LifeStyle Center (100%)
87

Patient Access Representative Resume Examples & Samples

  • Access the proper Epic application and accurately enters information necessary to begin/complete registration process
  • Maintain knowledge of current insurance regulations and policies
  • Verifies all insurance/self pay through online eligibility
  • .Responsible for identifying, collecting, and recording self pay, or co pay and/or deductibles when applicable prior to or at time of registration. Online posting of credit card payments
88

Patient Access Representative Resume Examples & Samples

  • Medical terminology is preferred
  • Previous registration experience is preferred
  • Intermediate skills with business computer software applications such as Microsoft Word, Excel, email, a scheduling program, and an admission software system is preferred
  • Knowledge of Medicare, Medi-Cal and commercial insurance plans and requirements is preferred
  • NAHAM certification is preferred
89

Associate Patient Access Representative Resume Examples & Samples

  • Two (2) years of experience specific to patient registration, insurance verification and/or financial counseling/billing or collections
  • Six (6) months of experience with insurance eligibility systems including Medicaid (Medi-Cal), Medicare and other commercial and private payer eligibility systems
  • Bilingual – fluent in English and Spanish
  • Knowledgeable of and demonstrated proficiency of the application of CPT and ICD-9 coding systems
  • Meditech experience
  • CHAM certification through the National Association of Healthcare Access Managers (NAHAM)
  • Associates/Bachelors degree in Healthcare, Business Administration or related field
  • Gains a deep knowledge of insurance benefits and understands fully the intricacies of third party liability and Workers’ Compensation
  • Ability to work with patients of all ages and explain payer benefits, while respecting the dignity, confidentiality and privacy of patients
  • Knowledgeable of all applicable compliance and legal requirements of the job based on the scope of practice of the position
  • Excellent verbal and written communication skills; able to relay complicated information from patient or family members to clinical staff
  • Exceptional customer service skills; must be able to cordially, professionally and effectively interact with patients, family members, physicians and other Medical Center personnel in a fast-paced environment
  • Able to build and maintain a cooperative working relationships with staff and clinical departments; able to work as part of a team, as well as able to work independently, be self-directed and work effectively with individuals that have a wide diversified background
  • Ability to handle cash and credit/debit card transactions, including collecting and refunding payments to patients; ability to balance a cash drawer
  • Able to maintain organizational, employee and patient confidentiality at all times
  • Ability to multi-task and prioritize needs to meet required timelines
  • Typing and basic computer skills; Ability to navigate health plan websites
  • Excellent knowledge of applicable rules/regulations/guidelines governing Managed Care and government sponsored coverage and reimbursement, to include in-network vs. out-of-network benefits
  • Knowledgeable of billing codes (DRG, ICD-9, CPT and HCPCS codes)
90

Associate Patient Access Representative Resume Examples & Samples

  • Registers patients, verifies and updates necessary information in the medical record
  • Maintains appointment book or appointment scheduler and follows office scheduling policies of the medical group/SWMP
  • Answers telephone, screens calls, takes messages and provides clerical information
  • Pulls and files charts, coordinates lab work
  • Sorts and delivers mail, medical records and other correspondence
  • Handling of precertification and referrals
  • Performs Trial Daily Close and completes daily banking deposits
  • Collecting co-pays and self pays
91

Patient Access Representative Resume Examples & Samples

  • Greets and directs patients and visitors for the entire facility to provide friendly and courteous services at all times. Dispense information and answers questions regarding the facility and its services
  • Demonstrate efficiency and familiarity with hospital systems in order to complete the registration process and financially secure the patient’s visit
  • Accurately enters Urgent Care (minor emergencies, x-ray, physicals), and Occupational Medicine services (drug screens, employment physicals, work-related injuries) into the GUI system, Patient Tracking Board, Rev Runner, Systoc, and Precision as outlined by the department’s policy and procedure manual. A complete registration is then done
  • Accurately completes the registration process for Lab (phlebotomy, cultures, specimens), and Radiology (CT, mammo, MRI, nuclear medicine, PET scan, ultrasound, DEXA, general x-rays) as outlined by the department’s policy and procedure manual
  • Responsible for contacting the Primary Care Physician and/or the precert staff specialist to obtain required insurance referrals and precerts when necessary
92

Emergency Department Patient Access Representative Resume Examples & Samples

  • Support and contribute to UPMC’s service excellence mission and abide by all UPMC departmental policies, procedures, goals, and values in the process of performing all job responsibilities. Incorporates acts of dignity and respect in daily interactions
  • Proper patient identification to start clinical record. Works independently to perform a timely patient interview and registration for services at the bed side. Obtains or updates necessary demographic and insurance related information. Confirms insurance eligibility, accountable for third party reimbursement and coordination of benefits to support a seamless billing process
  • Counsels patients regarding insurance coverage and expected financial liability. Collects and records patient payments including co-payments, co insurance, and deductibles on the day of service
  • Generates and completes all applicable forms and necessary communications. Obtains applicable signature for consent to treat and financial responsibility, along with signatures on any required forms, while following all HIPAA rules and regulations and maintaining patient confidentiality
  • Responsible for reconciliation and maintenance of First Net Emergency Department Tracking Board and Hospital ADT system
  • Completion of high school diploma or equivalent
  • Medical terminology and third party health care coverage experience preferred
  • Initiative to work productively with minimal supervision
93

Patient Access Representative Resume Examples & Samples

  • Ability to analyze and solve problems without waiting for direction and accepts responsibility
  • Ability to think independently and use good judgment for situations which require initiative and innovation
  • Knowledge of use of basic office equipment
  • Ability to multi-task, establishes work priorities, and prioritizes needs to meet required timelines
94

Patient Access Representative Resume Examples & Samples

  • Outpatient Surgery & SPU Pre-Registration /Registration
  • Verifies insurance for eligibility or maybe active coverage
  • Verifies the COB of insurances
  • Validates payer authorization/referral
  • Calculates point of service payments, estimated payments & refers patients to the financial counselor for payment arrangements
95

Patient Access Representative Resume Examples & Samples

  • Communication-
  • Confidentiality-
  • Change Management-
  • 1-3 years clerical experience preferred. Experience with medical terminology and insurance plans preferred. High School diploma required, some college helpful
96

Patient Access Representative Level Resume Examples & Samples

  • Data entry, medical terminology and insurance experience preferred
  • Medical setting experience preferred
  • Performs required pre-certification and deposit collection. Enters data in computer and thoroughly documents any incomplete admissions/registrations in manner prescribed. Obtains pre-certification, referral or authorization number and updates the patient’s file
  • Provides demographic information to insurance companies and calls physician’s offices as needed for pre-certification
  • Notifies patients or family members of any insurance coverage issues that may result in coverage reductions. Notifies patients of co-payments, deductibles or deposits needed
  • Completes Compliance Checker Process in accordance with Regulatory Guidelines. Reads physician order to differentiate patient registration type; i.e., pre-registration, registration, emergency and processes data accordingly
97

Patient Access Representative Resume Examples & Samples

  • High school diploma or equivalent is required
  • Two (2) years prior experience in a medical business office, hospital, or other customer service setting is required
  • Proficient typing (35 wpm minimum) keyboarding skills are required. Successful demonstration of PAR I competencies is required
98

Patient Access Representative Resume Examples & Samples

  • Demonstrates adherence to all policies and procedures. We are committed to the name "Paul Oliver Memorial Hospital" meaning excellence. We will provide services that meet our customers' requirements every time
  • As the first line of communication with the public and outside callers, this individual must create a professional image for Paul Oliver Memorial Hospital through outstanding telephone courtesy, pleasantness, the ability to keep their composure and the use of judgment and tact in dealing with others in normal working contacts
  • Maintain a professional working relationship with patients, patient's families, staff members, ancillary services, medical staff and present a good hospital image to the people inside and outside the organization in a manner that encourages teamwork
  • Based on knowledge of records and procedures must recognize potential problems and bring them to the attention of the appropriate person, use judgment when dealing with outside calls as to what information to give out and how to handle a problem call and to work effectively with other team members and departments
  • Receive all patient information from physician's office and ancillary departments, organize information for action and easy retrieval, gather and organize information in regard to medical histories and physical, lab, x-ray, EKG reports and other pertinent patient information from hospital departments and physician office for patient surgical and procedure charts in a timely manner
  • Must be able to obtain patient demographics from patients in a patient room and have conversations with patients to collect deductibles/co-pays
99

Patient Access Representative Resume Examples & Samples

  • Professionally greet ALL customers entering the hospital
  • Maintain positive interpersonal relations in dealing with patients and their families so that patients perceive a positive experience, which includes dissemination of information, resolving customer complaints, and routing patients to their destination
  • Demonstrates positive interpersonal relations in dealing with co-workers, physicians, physician's office staff, and other members of the health care team to achieve optimal customer service, departmental goals, efficiency, collegiality, Mercy values and quality care. Demonstrates ability to provide information, guidance, and assistance to patients and visitors
  • Maintain knowledge of paging systems, emergency systems, and has the ability to respond to all codes within the facility
  • Monitor the main entrance floors and parking lots and contact Maintenance or Environmental Services when necessary
  • Maintain, stock, and care for departmental equipment and supplies
  • Resolve customer complaints or escalate to appropriate person
  • Maintain proficiencies in all computer applications currently in department use
  • Perform order entry and activation through PowerChart
  • Work closely with physician offices to obtain accurate orders and diagnoses for outpatient testing
  • Coordinate with case managers, physician offices, ancillary departments and insurance company requirements for reimbursement
  • Verify patient insurance coverage and benefit eligibility via appropriate system with insurance companies. Communicate with patient and physicians office when scheduled ancillary testing is not covered by insurance or when patient is not eligible
  • Use Compliance Checker programs to screen for medical necessity and to determine need of advanced beneficiary notice (ABN)
  • Determine co-pay and deductible information from insurance eligibility and coverage inquiries
  • Demonstrate ability to accept payments from patients, record and issue receipts
  • Recognize self-pay accounts and collects payment or makes referral to appropriate Financial Counselor
  • Demonstrate ability to scan medical record chart and index appropriately
  • Independently identify accounts that need more attention and independently identify methods for resolving difficult accounts
  • Assist in the development and maintenance of departmental policies and procedures
  • Communicate with Central Scheduling to adjust schedule changes – i.e., cancellations, no shows and re-scheduled visits and walk-ins
  • Provide staff coverage and maintain proficiency in Lab and Pre-Admission testing
  • Demonstrates ability to maintain department records, reports and files as required
100

Patient Access Representative Resume Examples & Samples

  • Gathers necessary demographic and clinical information from patient and enters into appropriate database
  • Seeks appropriate resources to resolve issues about the type, date or location of prescribed procedures
  • Assists with coordination of activities related to insurance pre-certification/authorization
  • Provides counseling to patient or patient's representative regarding pre-service requirements and instructions
  • Verifies insurance for all patients scheduled by Patient Access Department as well as the Surgical Department
  • Advise patients of co-payment for surgery and in-patient maternity
  • 6 months computer experience required
101

Patient Access Representative Resume Examples & Samples

  • Enters patient insurance information into the patient record and documents insurance coverage of services to be provided
  • Determines financial responsibility for services to be provided. Notifies patients and/or practitioners of any services requested and/or referred that are not authorized by insurance
  • Minimum two (2) years of experience in a medical business office, physician office or hospital required. Minimum two (2) years of experience involving public contact and basic accounting practices required. Proficiency in all PAR I level responsibilities required
102

Patient Access Representative Resume Examples & Samples

  • Collect and records patient payments at time of service
  • Maintain working knowledge of all required computer systems
  • Routinely attend department meetings and on-going in-service and training programs, to present and exchange pertinent information
  • Schedule appointments according to the physician templates for similar types of physicians, generally at one office or multiple session timeshares (single specialty phone room or front desk environment)
  • Support and contribute to UPMC service excellence mission and abide by all UPMC departmental policies, procedures and goals in the process of performing all job responsibilities
  • Understand UPMC 72-hour appointment requirement and work to ensure guidelines are met
103

Patient Access Representative IV Resume Examples & Samples

  • Acts as an EPIC Super User and Customer Service Champion
  • Applies customer service and health care coverage experience to assist a broad range of clients, patients and families as it relates to admitting activities
  • Complete and make deposits for a team of PARs
  • Coordinates with study Coordinators coordinates to accession study blood draws and/or deliver communication on where and when samples are ready. (SHC ONLY)
  • Draft and reports weekly KPI metrics to unit
  • Leads team meetings and mentors lower level patient admitting representatives
  • Maintains professional communication with various PAS staff, medical center staff, physicians, guests, and patients regarding the admitting services rendered at Stanford Medical Center. Communication may consist of telephone correspondence or in person contact
  • Meets weekly individual productivity goals and standards while following planned priorities as set by the Team Manager/Coordinator
  • Performs Lab Intake which includes Laboratory blood draw check in and accessioning. (SHC ONLY)
  • Performs quality review checks on lower level team members
  • Performs Radiology intake which includes accessing RIS database to verify and/or release orders, schedule, and track appointments. (SHC ONLY)
  • Provide assistance with the monthly staffing schedule
  • The specific job duties will be comprised of a combination of responsibilities from among the various areas of PAS operations including: On-site, Ancillary, Financial Counselor, Acess Unit, and Emergence Department Registration
  • Knowledge of Medicare, Medi-Cal, Workers Comp, Managed Care (HMO, PPO, POS, etc ), Children's Health Programs (CCS, GHPP, Healthy Families, etc)
104

Patient Access Representative Modesto Resume Examples & Samples

  • Ability to manage own time and schedule own tasks while effective maintaining and documenting data in the patient registration systems as required. Must have initiative to work efficiently without constant supervision and direction
  • If Memorial Medical Center and/or own vehicle used on hospital business, must possess valid California driver’s license and upon request provide proof of liability insurance
  • Working knowledge and understanding of insurance and medical terminology desired
105

Associate Patient Access Representative Resume Examples & Samples

  • Data entry of all billing and collection information. (60%)
  • Submits all data for insurance verification and prior authorization of therapies.(90%)
  • Assembles reports and information to be transmitted via modem or computer for billing. (20%)
  • Serves as an effective resource person for customer/patient information on all insurance claims. Assists other departments regarding changes, claim status and procedures as needed. (80%)
  • Assembles reports as requested by Director or Finance department
  • Adheres to Texas Association for Home Care Code of Ethics
  • Conforms to all applicable Agency policies and procedures
  • Participates actively in continuing education and in-services
  • Maintains confidentiality of patient information and business trade practices
  • Assumes accountability for reporting incidents and complaints according to Agency policy