The Patient Access Representative supports patient access operations in the Emergency Department, serving as the primary liaison for patients and families in a fast-paced, high-acuity environment. This role facilitates timely patient flow, ensures accurate registration and insurance information, supports a clinically driven revenue cycle, and maintains compliance with CMS, HIPAA, managed care, and institutional requirements. The schedule is Monday through Friday, 9:30 a.m. to 6:00 p.m.
Responsibilities
- Register Emergency Department patients accurately, including demographics, insurance, and critical system data elements.
- Conduct patient and family interviews and explain and obtain required treatment, financial, privacy, and representative consents.
- Verify insurance eligibility and benefits, assess expected financial responsibility, and collect payments at the time of service.
- Perform eligibility screening and medical necessity reviews in collaboration with providers to support CMS compliance and prevent denials.
- Review provider orders for accuracy and completeness and follow up with physician offices as needed.
- Process patient accounts, document actions, answer account and coverage inquiries, and research registration issues to support payment.
- Scan documents into electronic medical records using Cerner Imaging functions.
- Collaborate with nurses, physicians, technicians, care coordinators, and other clinical staff to communicate registration status, delays, authorization issues, and factors affecting patient flow.
- Provide financial counseling regarding payment options and financial assistance.
- Resolve patient complaints and workflow issues when possible, escalating concerns to the Lead or Supervisor as appropriate.
- Provide billing and pre-certification information to physicians and assist with training new employees and staff members on procedures.
- Follow Patient Access and hospital policies, billing practices, third-party requirements, HIPAA regulations, and departmental procedures.
Required Qualifications
- High school diploma or GED; associate degree or equivalent work experience required.
- At least one year of experience in patient access services.
- Experience with patient registration, insurance verification, and eligibility and benefits verification.
- Knowledge of medical necessity screening.
- Experience using electronic health records, including Cerner.
- Understanding of HIPAA compliance requirements.
- Strong attention to detail and ability to work efficiently in a fast-paced Emergency Department setting.
- Effective patient communication skills, with sensitivity and professionalism when supporting patients and families under emergency or emotionally distressed circumstances.
InSync Consulting Services is a staffing agency specializing in Healthcare, Commercial, and EOR staffing services.
