Outpatient Access Rep

• 1. CUSTOMER SERVICE - Creates a patient/family, physician and employee experience that exemplifies caring, understanding, efficiency and overall quality of service. Demonstrates the ability to balance customer service with the financial needs of the hospital.
• 1.1 Identifies events where the service to a customer was less that optimal and escalates issues appropriately.
• 2. COMPUTER KNOWLEDGE - Maintains knowledge of current computer systems, for example those used in registration, scheduling, accounts receivable, patient care, patient tracking and Web based on-line eligibility systems.
• 2.1 Utilizes Microsoft packages.
• 3. REGISTRATION FUNCTIONS - Exhibits a thorough understanding of various insurance carrier/verification guidelines and knowledge of third party payor policies. Stays abreast of insurance changes as they affect the verification and processing of accounts. Takes appropriate actions to address problems when identified.
• 3.1 Verifies eligibility as outlined in departmental procedures.
  Assists in quality assurance audits utilizing various reports and/or worklists.
• 4. CHART PREPARATION - Ensures the timely generation and distribution of documents as required by departmental procedure to ensure timely processing of the patient's medical record.
• 4.1 Follows departmental procedures in obtaining required medical record documentation.

EDUCATION

High School graduate with demonstrated continuing education at a college level program or equivalent experience. Associate or Bachelor's Degree preferred.

EXPERIENCE

One or two years experience in a hospital Admitting/ED Registration Department with emphasis on registration, third party insurance verification and financial clearance dealing with all aspects of medical insurance and eligibility requirements preferred. Prior customer service experience required.

SPECIAL SKILLS

Excellent interpersonal skills and leadership ability. Has the ability to effectively communicate with all disciplines and all levels of customers. Strong working knowledge of PCs and related software to prepare a variety of reports. Must be able to work under constant pressure and use strong organizational skills. Must have knowledge of third party insurance, financial clearance, eligibility, billing & reimbursement, cash collection. Ability to interpret federal/state regulations and various governmental program guidelines (including free care). Demonstrates working knowledge of Medical Terminology. Bilingual (Spanish-speaking) ability is preferred.