Patient Access Representative Resume Samples

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J Bernier

Jade

Bernier

21213 Benedict Stream

Philadelphia

+1 (555) 118 6512

21213 Benedict Stream

Philadelphia

Phone

p +1 (555) 118 6512

Experience Experience

Philadelphia, PA

Patient Access Representative

Philadelphia, PA

Kuphal Group

Philadelphia, PA

Patient Access Representative

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

Los Angeles, CA

Patient Access Representative IV

Los Angeles, CA

Durgan-Rowe

Los Angeles, CA

Patient Access Representative IV

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)

present

Dallas, TX

Ohi Patient Access Representative

Dallas, TX

Bailey-McDermott

present

Dallas, TX

Ohi Patient Access Representative

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

Education Education

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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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

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

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

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

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

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

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

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

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

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

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

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

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)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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)

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

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

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

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

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

Patient Access Representative Resume Examples & Samples

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Patient Access Representative Resume Examples & Samples

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Patient Access Representative Resume Examples & Samples

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

Patient Access Representative Resume Examples & Samples

Highschool/GED
Insurance billing experience
Admitting experience

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

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

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.)

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

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%)

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

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

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)

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

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

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

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

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

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

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

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

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

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

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Patient Access Representative Resume Examples & Samples

Patient Access Representative Resume Examples & Samples

Patient Access Representative Resume Examples & Samples

Patient Access Representative Resume Examples & Samples

Patient Access Representative Resume Examples & Samples

Patient Access Representative Resume Examples & Samples

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