Patient Access Representative, Scheduling, Peabody

Registration:

Registers patients presenting for visits. Explains the registration process to patients and responds to patient questions.

Processes patient co-payments, co-insurance, deductibles and balances due.

Completes the Medicare Secondary Payer Questionnaire for each patient and adjusts patient coverage based on results.

Instructs patients and obtains signatures on consent forms, financial forms and other documents required by the clinical department; distributes documents to patients; scans, processes and records receipt of all documents collected during registration encounter.

Counsels patients regarding non-covered services, obtaining signatures on Advance Notice Beneficiaries (ABNs), consents and waivers.

Monitors patient waiting area for a smooth, efficient registration flow. Advises patients of potential delays and takes steps to ensure a pleasant patient experience.

Completes registrations on inpatient units who may be missing information from their original registration.

Responds to patient concerns and potential patient safety issues accordingly. Recognizes health conditions that are a possible risk to others and adheres to appropriate established procedures to help contain risk.

Assures a neat, orderly registration desk and patient waiting area, securing all confidential patient information.

Scheduling:

Initiates patient scheduling activities by prioritizing and accessing a variety of sources, including patient phone calls and digital messaging, orders, scheduled order work queues and MyChart.

Utilizes a variety of information sources to schedule, reschedule and cancel patient appointments. Information sources include online questionnaires, offline materials and subgroup searches.

Establishes working relationships with staff of assigned clinical departments. Understands and correctly applies unique clinical department scheduling protocols.

Remains current on scheduling protocols and applies judgment, or seeks management assistance, to ensure safe patient care when clinical department scheduling protocols do not meet patient needs.

Ensures all required key patient scheduling and registration information is captured and verified. Key information includes referring physician information, insurance coverage, demographics and contact information.

Identifies and communicates to Patient Access management issues that may impact the timeliness and accuracy of patient appointments and subsequent patient care.

Strictly follows confidentiality and equipment security and safeguarding guidelines when working in a remote setting. Maintains productivity, quality and accuracy levels and communicates regularly with the Supervisor and Manager.

Pre-Registration:

Efficiently registers patients, capturing and verifying all required information in order to identify the patient, contact the patient, and receive proper reimbursement for services on initial claim submission.

Ascertains, creates and assigns the guarantor for each patient, including personal/family relations, workers compensation insurance, third parties, behavioral health or others as required.

Identifies records and verifies patient insurance coverage using real time eligibility (RTE); reviews the insurer’s response to each verification request and takes appropriate action based on this response.

Applies the appropriate guarantor and insurance to each patient visit.

Communicates financial clearance status to patients. Advises patients of contract status, self-pay status and payment responsibility and schedules patients with Financial Counseling as needed.

Organizational Requirements:

Maintain strict adherence to the Lahey Hospital and Medical Center (LHMC) Confidentiality policy.

Incorporate LHMC Standards of Behavior and Guiding Principles into daily activities.

Comply with all LHMC Policies.

Comply with behavioral expectations of the department and LHMC.

Maintain courteous and effective interactions with colleagues and patients.

Demonstrate an understanding of the job description, performance expectations, and competency assessment.

Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards.

Participate in departmental and/or interdepartmental quality improvement activities.

Participate in and successfully completes Mandatory Education.

Perform all other duties as needed or directed to meet the needs of the department.