The Patient Access Representative 2 (PAR 2) facilitates a welcome and easy access to the facility and is responsible for establishing an encounter for any patient who meets the guidelines for hospital service. The PAR 2 ensures that all data entry is accurate, including demographic and financial information for each account. The PAR 2 has numerous procedural requirements, including data elements, insurance verification, and authorization for services; collections for all patient portions including prior balances; and balancing of cash at shift end. The PAR communicates directly with patients and families, physicians, nurses, insurance companies, and third-party payers. The PAR2 has the ability to, and serves as, team lead, lean Process improvement participant, new hire preceptor/mentor and/or auditor for regulatory and billing compliance.
Responsibilities
- Customer Service
- Effectively meets customer needs, builds productive customer relationships, and takes responsibility for customer satisfaction and loyalty.
- Represents the Patient Access department in a professional, courteous manner at ALL times.
- Asks patients if they may have special needs.
- Calls patients by name.
- Greets patients in a courteous and professional manner.
- Quality
- Adheres to the Passport accuracy percentage rate of 97.5 or above on a consistent basis when registering accounts.
- Supports the flexible needs of the department to accommodate patient volume in all areas of the hospital. This may require assignment to another area of the department, and shift change.
- Supports the department in achieving established performance targets.
- Completes training required as needed.
- Demonstrates reliability and dependability by reporting to work when scheduled.
- Financial Collections
- Calculates and collects the estimated patient portion, based on benefits and contract reimbursement as well as prior balances.
- Utilizes appropriate language and behavior to collect patient financial responsibility.
- Collects co-payments, deductibles, deposits and/or amounts due on previous accounts.
- Demonstrates knowledge and ability to review notes on all pre-admitted accounts and discuss with customer in a courteous and professional manner.
- Demonstrates knowledge and ability to review and explain previous accounts.
- Demonstrates knowledge and ability to complete account acknowledgement forms when appropriate.
- Collects cash, prints receipts, and balances cash drawers.
- Insurance and Benefits Knowledge
- Demonstrates knowledge of insurance plans.
- Verifies eligibility and obtains necessary authorizations for services rendered.
- Completes Medicare Secondary Payor Questionnaire.
- Utilizes online eligibility.
- Obtains authorization/verification of required insurance companies.
- Utilizes appropriate software and worksheets to calculate patient financial responsibility.
- Performs financial assessment for appropriate program assistance.
- Utilizes appropriate guidelines to assist patient with financial responsibility.
- Demonstrates accuracy in selected insurance plans (I-plans).
- Registration
- Obtains and accurately inputs all require data elements for registration, including patient demographic, financial information, guarantor information, and relevant notes associated with the encounter.
- Prioritizes and completes registration in a consistent, courteous, professional, accurate and timely manner.
- Ensures each patient is assigned only one medical record number.
- Selects appropriate patient type based on the department and services required.
- Communicates the purpose of and obtains patient/legal guardian signatures on all necessary hospital documents such as: hospital consent forms, assignment of benefits, patient rights, etc.
- Documents in account notes.
- Ensures orders are received and are consistent with tests/procedures.
- Gives patient documents that he/she needs to take with him/her to other departments.
- Leadership
- Serves in a team lead role (if assigned).
- Participates in/assists with performance improvement initiatives and demonstrates an understanding and compliance of all department policies and procedures.
- Mentors and trains other associates.
- Acts as auditor for regulatory and billing compliance.
- Other Duties as Assigned
- Performs all other duties as assigned.
Qualifications
Education: High School diploma or equivalent
Experience: 2 years relevant experience in the healthcare industry. Related certification (e.g. Certified Coder, Certified Medical Assistant) substitutes for 1 year of experience.
