Patient Access Rep
Company: United Regional Health Care System
Location: Wichita Falls
Posted on: May 28, 2023
Summary of Essential Functions:
- Knowledgeable of the insurance information required to properly
process insurance claims and ensure prompt payment.
- Knowledgeable of hospital policies concerning all admissions
- Fully versed in all aspects of the admitting office and the
emergency room functions and duties.
- Knowledgeable and obtain legal forms mandated by law.
- High School Diploma or equivalent.
- Must be able to communicate effectively in English, both
verbally and in writing.
- Clerical skills and background is needed to perform the
functions of the job.
- Admitting, insurance, collections and medical terminology are
- Clerical abilities (typing, spelling, and communication).
- Previous admitting/registration experience is helpful and
- Past collection and insurance experience is desired.
- Must type 40 wpm and good clerical, communication, spelling,
and public relation skills are required.
- Requires the use of office equipment, such as computer
terminals, telephones, copiers, 10 key calculators and other
various office equipment.
- Having patience and understanding is a must.
- Flexible hours/scheduled according to needs of the
- Ability to work under pressure and stress.
Duties and Responsibilities:
- Ensures that highest possible customer service is delivered to
both internal and external customers. Proactively approaches
dissatisfied customers and implements customer service recovery
measures to satisfy displeased customers.
- Conducts a thorough search of patient name against the Eclipsys
Master Patient Index (EMPI) in order to eliminate the risk of
duplicating or making errors in selecting the correct patient or
establishing a new Medical Record Number (MRN). Follows policy and
procedures that govern the naming conventions, search practices and
notification of changes to the MPI core data elements. Utilizes all
systems available to verify information provided by
patients/families. This includes collecting a copy of the
patients(s) or guarantor's drivers' license(s) and insurance
- Inputs third party payer information, according to what plan is
considered primary payer, secondary payer, etc. Establishes the
correct assignment of payer based on COB training materials. The
department sets performance targets associated with write offs,
denials and rejections. The target must be achieved in order to
meet performance expectations.
- To provide the highest possible customer service, patients are
preregistered 2 working days to 2 weeks in advance of
appointment/admission date daily. Contacts insurance company(ies)
and notifies them of the patient's admission within next business
day of admission and/or in accordance with Payer's contracted
guidelines. Works with Utilization Review department and
physician's offices to ensure that clinical requirements are
obtained. Enters all benefits and pre-cert information in the
account notes as instructed. Provides efficient documentation of
time and person whom talked to when obtaining benefits and
- Based on benefit information obtained from the patient's
insurance company, creates an accurate good faith estimate letter.
Utilizes all available resources to obtain CPT & Procedure Codes
i.e. CPT/Procedure Code books, websites, Medical Records Coding
Help Line ect.
- Provides patient/family with information on advanced
directives, patient rights, consent for treatment, and obtains
appropriate signatures. Prepares necessary patient packets and
completes charts. Scans insurance cards, patient identification
cards, and other admitting documents.
- Quotes patient's co-share responsibility (co-payments,
deductibles, & out of pocket amounts) to patient, negotiates
payment options that lead towards compliance and minimizes
collection expenses. Provides assistance applications to all
patients with no or inadequate funding.
- Documents receipts of funds from patient and gives copy to
patient at time of transaction. Files receipt of funds in
department files. Reconciles petty cash count and reports
overage/shortage to supervisor daily.
- Will follow established procedure to ensure that Medicare
Secondary Payer Questionnaire (MSPQ) are collected and accurately
entered into the registration system. Will insure that Medicare A
and/or Medicare B, along with any other applicable coverage, are
shown in the correct position(s) on the Insurance Plan Screen in
Eclipsys, and if not, to make the appropriate corrections.
- Completes special assignments completely and in a timely
manner, is quick to assist, demonstrates ability to work under
deadlines and pressure. Works with Management in a positive manner
when reporting trouble accounts.
- Performs all other tasks/responsibilities as necessary.
Keywords: United Regional Health Care System, Wichita Falls , Patient Access Rep, Other , Wichita Falls, Texas
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