The Patient Access Representative Senior's primary role includes
performing duties included in the Patient Access Representative job
description and supporting the work of Patient Access Departments.
Among other duties, this individual provides department education,
performs registration audits, and creates standard work as
designated by Patient Access Leaders. This role is also responsible
for coordinating representatives' efforts to resolve complex
accounts and ensuring representatives' interactions with patients
are consistent and compassionate during the registration.
The Patient Access Representative Senior helps to monitor all
registration and collection activities for the hospital and its
affiliates and serves as a day-to-day resource for
Nature and Scope
This position is responsible to conduct a comprehensive
registration with minimal assistance, in person or by phone. This
includes identifying all potential payer sources, including
federal, state and county assistance programs, which will ensure
reimbursement for the services being rendered. Whenever possible,
such screening will be done prior to admission. The incumbent is
responsible to ensure this process is expeditious, non-imposing and
insurance authorizations completed meeting payer requirements. This
position is accountable for timely coordination and accurate relay
of information pertaining to patient admissions and insurance
authorizations and potential denials by payers.
This position takes initiative to overcome roadblocks and
prioritize workload, ensuring that accounts are financially secured
and analyzed to ensure that all barriers / avoidable days are
identified and communicated to the appropriate personnel. The
incumbent must use diplomacy in communicating effectively to
patients, guardians, family members, physicians and co-workers. In
addition, the incumbent is responsible to coordinate with the
interdisciplinary teams to ensure a seamless admission and
discharge process. The incumbent will maintain all necessary
activity logs / required documentation with regard to insurance
authorizations and potential or actual denials as directed by their
The responsibilities of the Patient Access Representative Senior
includes but is not limited to the following:
- Performing technical aspects of work (80%) within team area of
responsibility while prioritizing time (20%) to allow for:
Developing team members through group, as well as one-on-one,
training and in-services.
Facilitating, implementing, monitoring, and appropriately
reacting to quality assurance mechanisms.
Monitoring and developing workflows to improve Patient
Developing and revising procedures relevant to the assigned
area, coordinated with other Patient Access teams.
Conducting data integrity audits and shares results with
representatives and department leadership; works with
representatives to improve performance as necessary.
Working with Patient Access Leadership to resolve operational
Co-development, communication, and tracking of progress towards
Ensuring patient financial liabilities are being properly
estimated and provided to the patient. Produces education for
Patient Access personnel to improve on financial collection
Participates in and/or assists with quality management
Working with Patient Access Leadership on department
- Acts as a resource for day-to-day operations questions.
- Serves as customer service resource for walk-in patients in
hospital lobby/patient registration area.
- Maintains a thorough understanding of federal and state
regulations, payer requirements, and third party financial
- Holds sufficient understanding of insurance protocols for
referrals, co-payments, deductibles, allowances, etc., and analyzes
information received to determine patients' out-of-pocket
- Trains and performs on-boarding for newly hired employees.
- Performs audits to ensure registration practices are compliant
with government payer regulations through registration audits,
authorization information is obtained for services from payers
(collect referrals and authorization numbers and document user
comment fields as appropriate).
- Ensures Patient Access personnel explain and obtain each
patient's signature on consent forms as needed. Makes copies of
insurance cards and patient identification.
- Collects and confirms complete patient demographic
information-including employer, financial information, emergency
contact, insurance, subscriber ID, etc.-and case-specific
information, such as referring physician/primary care provider and
- Collects out-of-pocket liabilities from patients upfront and
applies, adjusts, and reconciles daily point of-service cash
- Prepares and reconciles cash deposits as necessary.
The position is required to meet goals and productivity
standards set by management. This includes performing quality
assurance controls to ensure the final product produces a clean
claim and meeting collection goals. This position also performs
other duties as assigned by their direct and indirect supervisor /
manager / director.
This position is responsible to show through their actions the
highest level of professionalism in accordance with the Living our
Values. This includes adhering to dress code requirements and
taking initiative to make a genuine difference by optimizing our
patient's healthcare experience.
This position does not provide patient care.
The foregoing description is not intended and should not be
construed to be an exhaustive list of all responsibilities, skills
and efforts or work conditions associated with the job. It is
intended to be an accurate reflection of the general nature and
level of the job.
Requirements - Required and/or Preferred
Must have working-level knowledge of the English language,
including reading, writing and speaking English.
Requires the incumbent, at a minimum, to have been a Patient
Access Representative for at least 12 months. 6 months of Patient
Access Representative experience with a competency score of 95% or
higher may be accepted in lieu of 12 months Patient Access
Representative experience. Experience in acute hospital, surgical
center or outpatient center preferred.
Renown Health Patient Access Competency. Active CHAA
Computer / Typing:
Typing skills of 35-45 words per minute. Must possess, or be
able to obtain within 90 days, the computers skills necessary to
complete online learning requirements for job-specific
competencies, access online forms and policies, complete online
benefits enrollment, etc. Thorough knowledge and proficiency with
MSExcel and MSWord. Experience with EPIC system preferred.