PATIENT ACCESS REPRESENTATIVE (PD) 4PB03

Description

4PB03

PVH employment application required. All job offers contingent upon background check and completion of pre-employment physical.

This is an "as needed" position utilized to cover gaps in coverage including vacations, leaves of absence, and other instances of unfilled shifts.
 

Per diem employees are required to work a minimum of 3 shifts, within a 3-month period.

The Patient Access Representative plays a critical role in the patient’s encounter with Penobscot Valley Hospital by providing necessary and professional patient contact at the onset. This role is responsible for providing accurate and timely patient registration services, ensuring accuracy of demographic and insurance information, facilitates communication to and from other departments, and provides patients with their bill of rights, other necessary forms, and facilitates communication of insurance coverages. Serves as resource to employees (staff) and managers.  

JOB FUNCTIONS

A. Operations/Clerical

1. Represents the organization in all interactions with patients, staff, and visitors. Is an active professional member of an environment characterized by cooperation, collaboration, respect, and teamwork. Demonstrates adaptability to change and challenges and appropriately utilizes resources to achieve goals. 
2. Maintains adaptability in work schedule to meet patient and department needs. 
3. Will be assigned to duties by Manager, but will learn and be expected to be competent in all departmental processes in order to provide coverage or assist with large work volumes or projects. 
4. Greet customer with excellent customer service and calm demeanor, obtain the reason for visit to the hospital, and provide appropriate direction. 
5. Confirms patient identity by using date of birth and patient’s full name. 
6. Gather patient data and input demographic and insurance information into the patient registration system. Verify insurance information and patient demographic information if patient is unable to complete when they arrive (e.g. ER patient).
7. Strive to maintain 5% or less error rate over a 90 day average and complete an accuracy report (registration edits) before ending shift each day. 
8. Notify department of patient arrival.
9. Generate the patient’s chart and obtain appropriate signatures as required.
10. Direct or escort patient to the designated department or waiting area. May need to assist in the transport of the patient should they not be able to travel by themselves. May need to seek assistance from the clinical department when necessary if the patient is ill.
11. Answers telephone calls for the department and directs the call to the appropriate department/person.
12. Pre-registers patients for outpatient visits/testing or inpatient admissions.
13. Receive and process cash and credit payments.
14. Order supplies for the department as needed.
15. Coordinates multiple departmental visits.
16. Coordinate forms for patient category and make up folder.
17. Count cash at the beginning and end of each shift and document.
18. Run reports on census (Final census reports, Room changes, etc.)
19. Operate switchboard; transfer calls to appropriate departments.
20. Monitor ambulance service radio.
21. Operate in-hospital emergency line and page emergency codes as needed.
22. Operates Ipad Communication System.
23. Operate overhead paging system.
24. Operates beeper system.
25. Review scheduled patients’ list at time of scheduling and at least one week prior to visit to determine if required authorization, referrals, or quantity of visits is present. 

A) Contacts patient to verify all demographics, verify current insurance information, pre-register patient and provide guidance and direction for arrival at PVH. 

B) Discuss payment arrangements for deductible and co-pays. Notify PVH Patient Financial Representative and/or Collector of self-pay accounts. Use the PLE (Patient Liability Estimator) available through Trubridge to determine patient financial liability amount due.

1. Obtain authorizations/referrals/patient signatures as needed including ED, Observation, Swing Bed, Inpatient follow up tests, imaging, surgical, laboratory, and outpatient testing. 
2. Work with ancillary departments regarding referrals and authorizations. 
3. Document all conversations regarding prior authorizations/referrals with providers and insurance companies. Obtain call reference number’s, individual names, dates and times. Enter the information as a note on the patient’s account. 
4. Coordinate with Case Management on observation/inpatient authorizations. Promptly complete the appropriate sheet, email case management with pertinent information. 
5. Maintain patient status information in the computer system.
6. Review and scan observation and inpatient authorizations to patient’s account. 
7. Review all previous day’s registrations to verify insurance information present is correct. If none is listed, investigate to determine patient is not insured. 
8. Maintain authorizations and referrals filing system or database to review upcoming scheduled testing. 
9. Assist with updating and correcting patient accounts. 

Quality Improvement: Actively participates in the Hospital-wide Quality Improvement Program, actively supports and implements Department-specific Quality improvement initiatives and projects, recommends process improvement as appropriate, reports any quality issues in service delivery and consistently commits to a focus on quality improvement and organizational excellence. 

Disaster Management: As an employee of Penobscot Valley Hospital, the position has an inherent role to care for our community members when in need. To this regard, the incumbent will be expected to participate in emergency/disaster preparedness planning and drills as requested. When called upon during a real life disaster/emergency event, the incumbent will be expected to participate in the Hospital’s response to this event, within the scope of professional and personal ability to do so. 

Requirements

Associates Degree preferred. One year's experience in Patient Registration or equivalent prior healthcare/medical office experience preferred. 

Effective organizational skills and multi-tasking skills to manage a variety of tasks at once. 

Proficient in medical terminology and computer skills. Management of Aggressive Behavior (MOAB) course completion required. Can effectively demonstrate excellent verbal and written communication skills and a strong attention to detail. Professional demeanor and appearance appropriate for the job. 

Benefits  

PVH has a Section 125 Cafeteria Benefits Plan and pays a portion of the cost of our health plan, dental, basic life, and disability insurance for employees for 30+ authorized hours, and provides partial subsidy for dependent health insurance.  Part-time employees are eligible to receive dental, life, and disability coverage and are eligible to participate in the health insurance plan.  Other benefits include a 403(b) plan and earned time off accrual.