Patient Access Rep I

Core Competencies

Utilizes hospital bed board/patient tracking system to track and arrange proper placement of patient on nursing units.

Maintains basic working knowledge of all sponsored programs such as Medicare, Medi-Cal, Tricare and all other payers; as well as contracted insurance payers and authorization requirements.

Maintains proficient working knowledge of Medicare Secondary Payor Questionnaire policy and procedures.

Validates patient eligibility, benefits, and medical group affiliation as well as obtaining insurance verification and notification as needed. Validation may be performed via the telephone, payer website, or hospital registration application.

Demonstrates basic working knowledge of all department/regulatory generated documents and is able to explain their meaning to patients and obtains appropriate initials/signatures.

Bands patients appropriately and distributes labels/face sheets as necessary during the registration process.

Collects and returns patient valuables in accordance with department procedure in designated areas.

Creates estimates, requests, and collects patient financial responsibility payments for hospital services.

Greets customers promptly ensuring they are taken care of in a timely and professional manner.

Answers the telephone courteously within three rings, identifying self and department, routes calls, ascertains needs and takes accurate messages as appropriate.

Complies with departmental policies and procedures, demonstrates basic working knowledge of policies and procedures. References policies and procedures to explain to patient's, families, and physicians and other hospital staff.

Enters data related to HAV bed polls and notification to the administrative house supervisors/ or designee of any alerts via Reddi-Net when necessary.

Participates in interdepartmental committees and taskforce representing the Patient Access department.

Completes the Midnight Census compare and accurately makes all necessary changes in all applicable systems nightly as needed.

Participates in daily performance improvement huddles and hospital performance improvement activities using lean tools and techniques.

• Reviews physician order for completeness to ensure compliance during intake process.

Education