Patient Access Representative

The Patient Access Representative greets patients/family members and obtains and/or verifies demographic, clinical, financial and insurance information in the process of registering patients for service delivery, including the entry of patient/guarantor information in the patient accounting system, collection of patient signatures on all appropriate forms and the imaging/copying of registration documents. Obtains and processes signed physician orders, conducts online insurance eligibility/benefit verification on designated cases, notifies patient/guarantor and collects patient liabilities, and refers appropriate cases to financial counseling for follow-up and consultation. May provide escort and directional support to patients, family members and visitors.

Essential Functions:

  • Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.  
  • When assigned to work the reception desk, the position incumbent greets patients, family members and visitors in an appropriate and courteous manner, determining their need for assistance including directions, validation of parking tickets and escort or transport.  Utilizes judgment in the initial screening of the patient.  May adjust the sequence of registration/transportation based upon departmental guidelines and/or personal judgment when the health of the patient is in question.  Determines the type of service the patient is to receive by reviewing physician orders, the alphabetical patient schedule and/or by questioning the patient.  Refers the patient to the appropriate scheduling and/or ancillary department for follow-up and action if an outpatient test must be scheduled.  Will assign other staff/volunteers to patients to ensure that registrations/transportation functions are performed in a timely manner in order to avoid patient waiting periods.
  • May provide wheelchair assistance for those who require it or obtain immediate clinical support.  Escorts or transports patients and their belongings to their designated areas--ancillary departments, outpatient areas and nursing units, as warranted.  Assists in the distribution of registration forms, ID bracelets, patient ID plates and other items.
  • Performs activities that relate to registration in a variety of settings/locations and for multiple patient types (Inpatient Admissions, Outpatient Observation and Bedded Outpatients, Diagnostic Outpatients, Ambulatory Surgery, Emergency Department Registrations, Series accounts, Lab Specimens, etc.), dissemination of patient information.  Will be cross-trained to perform registration/intake functions for the above noted patient types.  Responsible for validating/obtaining and entering demographic, clinical, financial, and insurance information into the patient accounting system by interviewing the patient, family member and/or guarantor. Must obtain information in a variety of situations and in a professional, accurate, efficient, and courteous manner to ensure good patient relations and a smooth billing process.
  • Informs patient/guarantor of their liabilities and collects appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of check-in.  Provides financial education, referring the patient to financial counseling, as required.  In the collection of funds, documents payments/actions in the patient accounting system and provides the patient with a payment receipt.  
  • Validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance.  Contacts scheduling and/or ancillary department staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s).
  • Obtains signed physician orders for all tests and procedures from physicians/offices for testing and procedures.  Scans orders and other documentation (ID cards, Insurance cards, etc.) into the patient accounting system.   
  • Prepares identification bracelets and patient ID labels/plates for Inpatients and selected Outpatients.  May assist the patient in processing required insurance forms and obtains/scans patient/guarantor signatures on required forms (consent to treatment, assignment of benefits, release of information, waivers, ABNs, advance directives, etc.).  May audit & record the patient's valuables, securing appropriate authorizations, if needed.  Disseminates patient information, including patient guidebooks and other required documents.
  • May perform pre-registration functions on select patients by obtaining and entering information gained through patient contacts.  During pre-registration calls, provides information regarding directions, parking, transportation service, overnight accommodations, etc.
  • May perform cross-functional duties, including but not limited, to patient placement.  While performing reservation duties, the position is primarily responsible for making bed assignments and transfers, providing functional guidance as necessary and scheduling patients to be admitted.
  • May perform cross-functional duties, including but not limited, to patient placement.  While performing reservation duties, the position is primarily responsible for making bed assignments and transfers, providing functional guidance as necessary and scheduling patients to be admitted.  
  • Provides information, directions, transportation, and assistance to patients, family members and visitors, ensuring timely, customer-centric service delivery in an effective and efficient manner.  Communicates with various ancillary departments to ensure smooth patient flow and high data integrity. 
  • Prepares special reports as directed by the Manager to document utilization of the Patient Access department's services and patient flow (e.g., patient waiting time study, etc.). 
  • May serve as relief support, if the work schedule or work-load demands assistance to departmental personnel.  May also be chosen to serve as a resource to train new employees.  Cross- training in various functions is expected to assist in the smooth delivery of departmental services. 
  • Other duties as needed and assigned by the manager.
  • Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

Minimum Qualifications:

  • High school diploma or an equivalent combination of education and experience.  Associate degree preferred.  Data entry skills (50-60 keystrokes per minutes). Past work experience of at least (6) six months within a physician office, hospital or clinic environment, performing registration activities or an insurance company, performing payer activities are highly desired but not required  Working required Certified Healthcare Access Associate (CHAA) credentials by the National Association of Healthcare Access Management (NAHAM) is also preferred. 
  • Excellent communication (verbal and written) and organizational abilities.  Excellent interpersonal skills are necessary in dealing with peers, internal and external customers.  Accuracy, attentiveness to detail and time management skills are required. 
  • To successfully accomplish the essential job functions of this position, the incumbent will be required to work independently, read, write, and operate keyboard and telephone effectively.
  • Must be comfortable operating in a collaborative, shared leadership environment.
  • Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.