Patient Access Representative I OR II
Company: Tahoe Forest Health
Posted on: March 16, 2023
This position is Sign On/Referral Bonus Eligible
Eligible for shift differential pay when working evening, night, or
Bargaining Unit:Non Licensed
Rate of Pay
Patient Access Rep I - $23.35/HR + DOE
Patient Access Rep II - $25.78/HR + DOE
Under the general supervision of the Patient Access Director, this
position performs imperative duties including but not limited to
appointment scheduling, registration, insurance verification,
telephone coverage, patient collections, registration follow up,
and customer service. Acts a trainer and/or subject matter expert
Hours and Place of Work
Required to be available for standby.
Scheduled to work in Truckee and IVCH facilities as needed.
Essential Duties and Responsibilities
- Registers patients by verifying identity and interviewing
patient or representative in a pleasant, professional, and timely
manner according to department practices.
- Ensures all necessary demographic and financial data is
obtained and accurately entered into the electronic health record
- Scans all necessary insurance information, including insurance
cards, personal identification, driver's license, physician order,
etc. into EHR.
- Validates existing data related to prior registrations by
asking patient to repeat all data and updating appropriately in the
- Identifies appropriate payor sources and verifies eligibility
according to department procedure for all patients.
- Checks to ensure authorization has been obtained prior to
services being rendered. If authorization is not in place, follows
Financial Clearance policy. Creates and discusses Intent to Proceed
with a Non-Authorized Service forms as needed. Scans all
appropriate documentation into the EHR.
- Refers all private pay and underinsured patients to the
Financial Counselors or Eligibility Advocate.
- Initiates patient financial conversations with respect and
privacy. Creates estimates for services and delivers to patient.
Collects estimated amount due per TFH Financial Clearance Policy.
Documents all estimates, conversations, and collections in
- Understands and can explain hospital payment options to
- Holds sufficient understanding of insurance protocols for
orders, authorizations, referrals, co-payments, deductibles,
allowed amounts, etc.
- Maintains and updates knowledge regarding all types of
insurance and healthcare coverage, utilizing reference materials
provided, when necessary.
- Understands and follows all regulatory requirements including
but not limited to: Emergency Medical Treatment and Labor Act
(EMTALA), Health Insurance Portability and Accountability (HIPAA),
and Red Flag Rules.
- Performs alternate provider workflow for not on staff providers
including, NPI check and OIG Exclusion List checks. Documents all
information in EHR.
- Informs patients of and obtains signatures timely for all
registration forms including but not limited to: Conditions of
Admission, Guide to Billing and Financial Assistance, Patient
Rights and Responsibilities, Notice of Privacy Practices,
Acknowledgment of Patient Information on Advance
Directives,Important Message from Medicare, and California
- Possesses knowledge of and can explain all forms, required
registration information, and procedures as needed.
- Creates armbands, labels and other documentation as necessary.
Places armbands on patients following appropriate policy and
- Obtains worker's compensation accident information when
applicable. Calls patient employer to verify employment. Obtains
all insurance information from employer timely. Contacts insurance
company to gather claim information. Enters all information into
- Performs cashier functions for all patients who present cash,
check or credit card as payment for services. Requests, processes,
and deposits all payments per department cash handling policy to
promote stewardship of District resources.
- Completes Medicare Secondary Payor Questionnaire and documents
responses in EHR.
- Uses EMR to check local coverage determinations for Medicare
patients as needed. Generates and produces Advanced Beneficiary
Notices (ABN's). Delivers to patients and documents in EMR.
- Assists patients with filling out medical records release
forms. Verifies patient identity and documents on forms. Sends all
Release of Information (ROI) forms to Health Information Management
- Schedules patients for walk-in services. Assists in scheduling
patients at check out.
- Utilizes patient schedules to prepare for patient appointments
when possible including but not limited to: missing registration
items, patient estimates, forms, schedules, and notes.
- Promptly answers phone calls at work station and directs to
appropriate area as necessary. Acts as District operator coverage
outside of business hours or as needed.
- Displays exceptional customer service with patients, visitors,
and peers at all times by addressing and treating all with respect
- Attends and engages in department meetings, projects, teams,
trainings, and committees.
- Utilizes interpreter service to communicate with patients when
- Performs quality checks, reports, audits, note-taking, and
other clerical tasks for department when requested.
- Keeps all applicable certifications active. Provides proof of
certifications when requested. Ensures current certification are on
file in Human Resources.Works EMR work queues during each shift.
Follows up on all items including: pre-registration and
pre-admission missing registration items, emergency room visit
missing registration items, appointment missing registration items,
admission missing registration items, discharged patient missing
registration items, returned mail, claim edits, stop bills, and
- Checks email several times during shift and responds
- Completes all job functions with discretion ensuring patient
- Stores patient's valuables and documents appropriately.
- Responds to emergency calls and pages emergency announcements
in accordance with emergency response policies.
- Performs hospital front desk duties. Receives visitors, obtains
name and nature of business, and provides information and
- Works shift and area as assigned on schedule. Is cross trained
in different coverage areas of Patient Access when requested.
- Enters safety, feedback, and disruptive event reports as
- Displays critical thinking at all times.
- Actively looks for solutions and shares ideas for improvement
- Maintains proactive and positive communication with management
team, peers, and patients at all times.
- Exhibits professionalism in appearance, speech and conduct
following department dress policy at all times while on shift.
- Acts as leader of assigned inter-department committee or team.
Is responsible for deliverables in moving team forward.
- Works on special projects as assigned.
- Acts as subject matter expert on assigned quality checks,
reports, and audits for department.
- Acts as mentor and operational trainer to new team members in
conjunction with Registration Coordinators. Trains, validates, and
competency checks new team members. Communicates progress of
trainee to Supervisors and Registration Coordinators.
- Attends and actively participates in training of operational
trainers. Stays current on all training methods and tasks.
Participates in continuing education of operational trainers.
- Demonstrates System Values in performance and behavior.
- Complies with System policies and procedures.
- Other duties as may be assigned.
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
No supervisory responsibilities.
Education and Experience
High school diploma or general education degree (GED) required;
Associate's or Bachelor's degree in healthcare administration,
business administration or related field desired. One to two years
patient registration experience preferred or equivalent combination
of education and experience.
Required: CHAA Certified Healthcare Access Associate (Required for
Patient Access Representative II)
Required: CPR certification within six months of employment or for
employees hired prior to 5/17/2019 by 12/1/2019.
Customer Service experience preferred.
Keywords: Tahoe Forest Health, Reno , Patient Access Representative I OR II, Other , Truckee, Nevada
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