Erie County Medical Center PATIENT ACCESS SERVICES REPRESENTATIVE in Buffalo, New York
Graduation from high school or possession of a high school equivalency diploma and one (1) year of clerical experience* in patient admissions, patient registration, patient appointment scheduling, health insurance verification, health insurance eligibility or health insurance processing in a healthcare setting or third party payer setting.
NOTE 1: *Graduation from a regionally accredited or New York State registered college or university with a Bachelor's Degree may be substituted for the required qualifying experience.
NOTE 2: Verifiable part-time and/or volunteer experience will be pro-rated toward meeting the full-time experience requirements.
TYPICAL WORK ACTIVITIES:
Pre-registers and/or registers patients for various locations throughout ECMCC such as Emergency Room, clinics, inpatient, surgical and ancillary services using computer information systems;
Schedules patient appointments, gathers demographic information including payer information and inputs into computer information systems;
Obtains insurance information required for hospital billing, including completion of the Medicare Secondary Payer Questionnaire; performs work related to patient health insurance eligibility such as obtaining and verifying preauthorization approval for procedures, receiving authorization errors and making corrections to errors; inputs information into the electronic computerized system;
Verifies third party payers using telephone or online verification systems;
Determines insurance co-payments due from patient at time of service; collects required amounts at time of pre-registration and/or registration and issues receipts;
Identifies and interview patients without insurance to assess qualifications for government entitlement programs or uncompensated charity care programs in accordance with hospital policy;
Obtains signatures on various forms;
Provides feedback to appropriate person of missing/incorrect information so it can be obtained at the point of service;
Provides patients with information and responds to inquiries regarding appointment scheduling, registration, payment, repayment services, etc.;
Identifies related issues and works with other departments and outside entities to resolve;
Refers patients to staff responsible for developing contractual payment plans;
Operates bed board system assigning beds appropriate to cohort specifications, hospital transfers, direct admissions and various bed board functions;
Complies with applicable federal and state regulatory agency guidelines, including Health Information Portability and Accountability Act of 1996 (HIPAA) privacy standards, established departmental policies and procedures, objectives, quality assurance, safety, environmental, infection control standards, etc.;
Performs a variety of related clerical duties as required.
FULL PERFORMANCE KNOWLEDGES, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS: Good knowledge of the principles and practices of patient registration, patient scheduling, health insurance eligibility and health insurance verification and eligibility in a hospital setting; good knowledge of applicable laws, rules, regulations and accreditation standards as they relate to patient registration, patient scheduling, health insurance eligibility and health insurance verification and eligibility in a hospital setting; good knowledge of third party payers and the respective guidelines associated with respective payers; working knowledge of medical terminology; strong customer service skills; good interviewing skills; ability to use an alpha-numeric keyboard; ability to apply basic mathematical functions; ability to communicate effectively, both orally and in writing; ability to establish and maintain effective working relationships with a diverse constituency; ability to utilize a variety of electronic software applications; sound professional judgment; capable of performing the essential functions of the position with or without reasonable accommodation.
DISTINGUISHING FEATURES OF THE CLASS: The work involves performing a variety of clerical functions related to the registration of patients for clinical, surgical, inpatient and ancillary departments at the Erie County Medical Center Corporation. The incumbent performs tasks such as obtaining and reviewing patient information, scheduling patient appointments, verifying benefits eligibility, calculating and receiving patient co-pay, and inputting information into computer information systems. The work is performed under the direct supervision of a higher-level Revenue Cycle or Ambulatory Services employee. Supervision is not a function of this position. Does related work as required.