Job Details

Patient Access Representative

Responsible for a wide range of duties in support of departmental efficiencies which may include but not limited to performing registration, patient pre-admission and admission, reception and discharge functions, arranging support hospital services requested by patients through referrals, performs thorough analysis of admission discharge transfers (ADT), revenue cycle reports, leads shift patient access operations, and collaborates with department leaders in process and operational excellence.

Include the following. Others may be assigned.

1. Greeting patients following Conifer standards of care, provides world-class customer service, completes full patient registration at date of service adheres to financial & cash control policies & procedures, thoroughly explains and secures hospital & patient legal forms (i.e., advance directives, conditions of services, consent for treatment, important message from Medicare, EMTALA, etc.). Scan protected health information, create and file patient information packets/folders for upcoming hospital services. May also assist with scheduling diagnostic or surgical procedures, conducting physician office/patient interviews, and explains hospital procedure guidelines and policies.
2. Provides full patient financial counseling, education & referrals, employs and completes all patient liability collection escalations through proper, compliant patient liability collection techniques before, during & after date of service, performs hospital cash reconciliation & secured payment entry in adherence to financial & cash control policies & procedures.
3. Secures medical necessity checks/verification in accordance to centers for Medicare & Medicare services, verifies insurance, benefits, coverage & eligibility, completes assigned registration financial clearance work lists activities, obtains insurance authorizations for scheduled & unscheduled hospital services, and secures inpatient visit notification to payors.
4. Performs thorough analysis of admission discharge transfers (ADT), revenue cycle reports, leads shift patient access operations, and collaborates with department leaders in process and operational excellence.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Minimum typing skills of 35 wpm
• Demonstrated working knowledge of software/system/equipment/PCs.
• Knowledge of function and relationships within a hospital environment preferred
• Advance customer service skills and experience
• Ability to work in a fast paced environment
• Ability to receive and express detailed information through oral and written communications
• Advanced understanding of third party payor requirements preferred
• Advanced understanding of compliance standards preferred
• Advanced patient liability collection performance and high achievement in productivity.
• Must be able to perform essential job duties in at least three patient access service areas including ED
• Uses proper negotiation techniques to professionally collect money owed by our patients/guarantors.
• Builds and maintains collaborative relationships with both internal and external clients that lead to more effective communication and a higher level of productivity and accuracy.

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

Include minimum education, technical training, and/or experience preferred to perform the job.

• High school diploma or GED required.
• 2-4 years experience in medical facility, health insurance, or related area.
• 2+ years in patient access preferred.
• Some college coursework is preferred.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must be able to sit at computer terminal for extended periods of time.
• Occasionally lift/carry items weighing up to 25 lbs.
• Frequent prolonged standing, sitting, and walking.
• Occasionally push a wheelchair to assist patients with mobility problems.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Hospital administration.
• Can work in patient care locations which include potential exposure to life-threatening patient conditions.

Must be available to work hours and days as needed based on departmental/system demands. Resolves physician's office and patient issues. May experience extreme patient volumes and uncooperative patients.