Franciscan Missionaries of Our Lady Health System
Patient Access Representative 1 - Hospital
Franciscan Missionaries of Our Lady Health System, Baton Rouge, Louisiana, us, 70873
Overview
The Patient Access Representative 1 (PAR1) is responsible for accurately registering inpatients, outpatients, and/or ER patients in the EMR, including validating patient information, verification of insurance coverage, calculation of and collection of patient co-insurance/deductibles/co-pays, authorization for services, and balancing of cash. The PAR1 ensures the patient\'s experience is best in class and demonstrates effective communication with patients and families, physicians, nurses, and insurance companies. The PAR1 is knowledgeable of and compliant with federal and state regulations related to acute-care patient registration. Responsibilities
Registration
Obtain necessary information from patient, including demographic information, insurance, guarantor, and input into registration software. If patient is already in the system, verify the correct patient record. Represent the Patient Access department professionally, courteously, and to meet customer needs; greet patients and call them by name; prioritize and complete registration accurately and timely. Use critical thinking to tailor the registration experience based on patient circumstances; apply applicable federal and state laws (EMTALA, HIPAA, Balanced Billing Act, ABN, MSPs, and state regulations on notification of out-of-network status) to ensure compliant registration. Ensure each patient is assigned a single medical record number. Obtain patient/legal guardian signatures on necessary hospital documents (e.g., consent forms, assignment of benefits, patient rights). Document encounters thoroughly to support cross-function communication. Ensure orders are received and consistent with tests/procedures. Monitor waiting room, facilitate patient flow, and resolve issues regarding orders or missing/conflicting information to ensure timely and accurate registration.
Insurance and Benefits Knowledge
Demonstrate knowledge of insurance plans, including payer rules and prior authorization requirements. Verify eligibility (using online tools when possible) and obtain necessary authorizations for services rendered. Select correct insurance plans in the registration software in the correct order (primary vs secondary). Understand forms (including Medicare Secondary Payer Questionnaire) and explain them to patients. Utilize payment estimator software to calculate patient financial responsibility; verify accuracy of output. Determine eligibility for financial assistance and direct patients to appropriate resources.
Financial Collections
Use customer service techniques to collect the patient financial obligation at or before the time of service; negotiate deposits per policy. Explain out-of-pocket calculations; analyze documentation to explain balances to patients. Complete account acknowledgement forms when appropriate; collect cash and balance drawers.
Other Duties as Assigned
Performs all other duties as assigned.
Qualifications
Education: High School diploma or equivalent. Experience: 1 year customer service experience or related certification (e.g., Certified Coder, Certified Medical Assistant) substitutes for 1 year of experience. Senioriry level
Entry level Employment type
Full-time Job function
Health Care Provider Industries
Hospitals and Health Care Note: Removed extraneous posting references and promotional lines.
#J-18808-Ljbffr
The Patient Access Representative 1 (PAR1) is responsible for accurately registering inpatients, outpatients, and/or ER patients in the EMR, including validating patient information, verification of insurance coverage, calculation of and collection of patient co-insurance/deductibles/co-pays, authorization for services, and balancing of cash. The PAR1 ensures the patient\'s experience is best in class and demonstrates effective communication with patients and families, physicians, nurses, and insurance companies. The PAR1 is knowledgeable of and compliant with federal and state regulations related to acute-care patient registration. Responsibilities
Registration
Obtain necessary information from patient, including demographic information, insurance, guarantor, and input into registration software. If patient is already in the system, verify the correct patient record. Represent the Patient Access department professionally, courteously, and to meet customer needs; greet patients and call them by name; prioritize and complete registration accurately and timely. Use critical thinking to tailor the registration experience based on patient circumstances; apply applicable federal and state laws (EMTALA, HIPAA, Balanced Billing Act, ABN, MSPs, and state regulations on notification of out-of-network status) to ensure compliant registration. Ensure each patient is assigned a single medical record number. Obtain patient/legal guardian signatures on necessary hospital documents (e.g., consent forms, assignment of benefits, patient rights). Document encounters thoroughly to support cross-function communication. Ensure orders are received and consistent with tests/procedures. Monitor waiting room, facilitate patient flow, and resolve issues regarding orders or missing/conflicting information to ensure timely and accurate registration.
Insurance and Benefits Knowledge
Demonstrate knowledge of insurance plans, including payer rules and prior authorization requirements. Verify eligibility (using online tools when possible) and obtain necessary authorizations for services rendered. Select correct insurance plans in the registration software in the correct order (primary vs secondary). Understand forms (including Medicare Secondary Payer Questionnaire) and explain them to patients. Utilize payment estimator software to calculate patient financial responsibility; verify accuracy of output. Determine eligibility for financial assistance and direct patients to appropriate resources.
Financial Collections
Use customer service techniques to collect the patient financial obligation at or before the time of service; negotiate deposits per policy. Explain out-of-pocket calculations; analyze documentation to explain balances to patients. Complete account acknowledgement forms when appropriate; collect cash and balance drawers.
Other Duties as Assigned
Performs all other duties as assigned.
Qualifications
Education: High School diploma or equivalent. Experience: 1 year customer service experience or related certification (e.g., Certified Coder, Certified Medical Assistant) substitutes for 1 year of experience. Senioriry level
Entry level Employment type
Full-time Job function
Health Care Provider Industries
Hospitals and Health Care Note: Removed extraneous posting references and promotional lines.
#J-18808-Ljbffr