Patient Access Rep I

Responsibility

Summary: Under the direction and supervision of the Patient Registration Manager and in accordance with Hospital and Patient Registration Department policies and procedures: Registers outpatients, Admits, Discharges, and transfers patients to all levels of care within the Finger Lakes Health system. Interviews all patients and processes all pertinent patient information (demographic and financial). Verifies insurance coverage. Determines and facilitates obtaining the proper authorizations and pre-certifications required by insurance carrier guidelines. Is knowledgeable of and adheres to all Finger Lakes Health and Patient Registration department policies and procedures.

Essential Job Functions:

(Maximum of the first 5 will be included in the performance appraisal)

Represents the health system in a customer friendly and professional manner, facilitating patient access to care/services provided by FLH. Is knowledgeable of and adheres to all Finger Lakes Health and Patient Registration department policies and procedures.

Obtains, verifies, and updates patient demographic/insurance/medical information and enters data accurately into the facility's computer system. Determines and collects all applicable co-payments, patient payments, and deposits. Processes cash receipts and balances cash drawer.

Interviews patient and adheres to all policies and procedures for ensuring positive patient identification and preventing identify theft. Accurately completes the required Medicare Secondary Payer questionnaire on all Medicare patients processed, to determine all possible insurance coverage and primary payer. Enters diagnostic information to facility's computer system with no variation from the physician order forms. Remains mindful of the impact that data accuracy has on other departments, the patient’s account/electronic medical record, and patient/customer satisfaction.

Possesses a thorough knowledge of Registration Representative's role in disaster situations. Stays knowledgeable and adheres to all industry wide regulations (Federal, State, JCAHO, HIPAA, Payer regulations, etc.) as they pertain to patient registration functions. Is knowledgeable of regulatory agencies functions (monitoring, surveying, reporting, etc.) and applications in patient registration.

For patients/guarantors not previously completely processed by PSR, determines the appropriate party responsible to make health care and financial decisions related to the patient's care. Adheres to all facility and department policies and procedures for providing required patient information. Explains forms and obtains signatures from the patient/responsible party for: Payment agreement, Assignment of benefits, Medicare patient agreement, Release of information, Coordination of benefits, Personal property statement, Patients’ Bill of Rights, An Important Message from Medicare, Privacy Notice, and Medicare Advance Beneficiary Notice. Understands the Medicare Fraud and Abuse guidelines and penalties for submitting false claims and for improper coding.