Patient Access Representative
Company: West Suburban Medical Center
Location: Oak Park
Posted on: June 22, 2022
Job DescriptionJOB SUMMARY:Under general supervision, provides
quality service registration for inpatient and outpatient
encounters. Accurately collects, analyzes, and records demographic,
insurance/financial, and clinical data from multiple sources, and
obtains other information and signatures necessary for scheduling,
registration, and billing. Effectively screens for compliance with
payer requirements for medical necessity and pre-certification and
completes third-party eligibility and benefit verification to
ensure accurate payment is secured. Interacts in a customer-focused
and compassionate manner to ensure patient's and their
representatives' needs are met, and that they understand the
hospital's revenue cycle expectations, including resolution of
personal liabilities through various payment options. JOB
QUALIFICATIONS1. High School diploma. 2. Two years of admitting
experience. 3. Medical terminology preferred. 4. Must speak and
write English.JOB DUTIES (* denotes "essential function") 1.
Demonstrates the WSMC Customer Service Values, which are key in
providing quality service to patients and customers. 2. Registers
patients in a timely, accurate, efficient manner. Identifies chief
complaint or diagnosis. Determines correct demographic, financial,
and insurance information. 3. Collects the patient liability for
each visit, decides for payment according to policy, or refers the
patient to the proper person to arrange payment. 4. Contacts
physician's office or ancillary area to clarify diagnosis, symptom,
nature, or sequence of ordered services. 5. Enters charges, breaks
down and distribute charts, completes, and discharges patients
through the system. 6. Registers and routes patients to physicians'
offices, and answers telephones. 7. Reviews reports as assigned and
makes appropriate corrections in system. 8. Reviews physician
orders and other documentation against payer coverage and medical
necessity criteria; uses screening software to determine whether
services being provided meet third-party requirements for payment.
9. contacts physicians as necessary for additional clinical
information; informs physicians about payer requirements; initiates
the Medical Advance Beneficiary Notice as appropriate; and explains
payer policies to patient. 10. Interprets physician orders for
service, uses appropriate accommodation and service codes, and
establishes account parameters to ensure revenue is properly
recorded and accurate bills are produced.11. Assists with
transportation of patients within the hospital. 12. Accurately
collects and analyzes all required demographics,
insurance/financial, and clinical data necessary to schedule,
pre-register, and register patients from all payer classes.
Interacts with patients, their representatives, physician office
staff, employers, and others, and reviews new and previously
recorded information. 13. Follows EMTALA, HIPAA, payer, and other
applicable regulations and standards for registration. 14.
Appropriately explains, secures, and witnesses all signatures
required to provide medical treatment, assign insurance benefits,
release information, establish financial responsibility, and meet
other internal, regulatory, or payer requirements. 15. Completes
the Medicare Secondary Payer (MSP) questionnaire when applicable.
Accurately prepares required forms, documents, and reports,
including labels, patient ID Bands, medical record forms, death
certificates, and other special documents. Produces and distributes
these on a timely basis to both internal and external parties.
Keywords: West Suburban Medical Center, Oak Park , Patient Access Representative, Other , Oak Park, Illinois
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