Patient Access Representative 2

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Pay Range:

$18.57 - $23.23

Scheduled Weekly Hours:

40

Position Overview

SUMMARY (Basic Purpose of the Job):

Registers patients accurately, efficiently, and, independently to ensure database integrity. Maintains financial integrity of all of front-end registration and insurance verification functions while upholding the utmost in customer satisfaction. Applies all financial screening guidelines and maintains up-to-date knowledge and adheres to all payors and regulatory guidelines for medical insurance claims for processing and reimbursement. Develops and maintains solid relationship with physician offices and function as a liaison between offices at Capital Health.

MINIMUM REQUIREMENTS:

Education: High school diploma or equivalent.

Experience: Six months in Patient Access Rep I role at Capital Health or one year customer service experience with medical terminology.

Knowledge and Skills: Excellent communication, interpersonal and organizational skills. Ability to problem solve and multitask and manage frequent interruption. Expert and current knowledge of all aspects of insurance requirements.

Special Training: Proficient computer skills. Familiar with medical terminology. A quality of knowledge of insurance plans and insurance experience preferred.

Mental, Behavioral and Emotional Abilities: Ability to work independently and as a team. Maintains composure in high pressure or fast-paced environment.

Usual Work Day: 8 Hours  

ESSENTIAL FUNCTIONS:

• Expert in identifying participating CH insurance plans and ability to identify non-participating plans.
• Demonstrates service excellence by professionally assisting patients and customers with the utmost respect in a friendly, caring manner.
• Proficient in registering patients quickly and accurately, exceeding productive levels of a Patient Access Rep I. Correctly identify a patient according to policy, complete all patient registration types by collecting and entering accurate patient demographics, physician information, insurance information, and valid registration-specific codes. Obtains all necessary signatures. Assures insurance information is verified, and authorization is obtained if not done prior to the service. Essential registration forms are scanned into EMR, and chart follow-up is performed.
• Performs all job duties independently with minimal supervision.
• Follows all payor requirements and identifies needs for referrals and precertification. Performs verification of benefits on all patient encounters. Reviews chart for accuracy.
• Follows computer system, internet- based insurance applications, and department operational procedures and training guidelines to obtain accurate demographic, diagnosis, authorizations/referrals, and insurance information on each registration.
• Works collaboratively with other departments, physicians, and physician office staff to obtain essential registration information such as insurance authorization, referrals, diagnosis and scripts to secure financial reimbursement and customer/patient satisfaction.
• Complies with department procedures and regulatory guidelines for Medicare Secondary Payer, Medicare Medical Necessity Regulations, Collection of co-pay, Advance Beneficiary Notice, Advance Directives and Patient's Rights.
• Ascertains and records appropriately the difference between primary care physician, referring physician, and attending physician.
• Utilizes Insurance Card Database and/or Insurance Verification guidelines. Follows Financial Screening and Self Pay Procedure with regards to referrals for Medicaid and Charity Care.
• Assists and supports with staff departmental training. Attends all mandatory department meetings.
• Supports and participates in department performance improvement initiatives.
• Performs other duties as needed.

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

Frequent physical demands include: Sitting , Standing , Walking , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion

Occasional physical demands include: Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl

Continuous physical demands include: Talk or Hear

Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.

Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Depth Perception, Accurate Hearing

Anticipated Occupational Exposure Risks Include the following: Bloodborne Pathogens , Airborne Communicable Disease , Extreme Noise Levels , Dust/Particulate Matter

This position is eligible for the following benefits:

• Medical Plan

• Prescription drug coverage & In-House Employee Pharmacy

• Dental Plan

• Vision Plan

• Flexible Spending Account (FSA)

- Healthcare FSA

- Dependent Care FSA

• Retirement Savings and Investment Plan

• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance

• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance

• Disability Benefits – Long Term Disability (LTD)

• Disability Benefits – Short Term Disability (STD)

• Employee Assistance Program

• Commuter Transit

• Commuter Parking

• Supplemental Life Insurance

- Voluntary Life Spouse

- Voluntary Life Employee

- Voluntary Life Child

• Voluntary Legal Services

• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance

• Voluntary Identity Theft Insurance

• Voluntary Pet Insurance

• Paid Time-Off Program

The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level. 

The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.