Job DescriptionThe Patient Access Representative 1 (PAR1) is responsible for accurately registering inpatients, outpatients, and/or ER patients in the EMR, including validating patient information, verification of insurance coverage, calculation of and collection of patient co-insurance/deductibles/co-pays, authorization for services, and balancing of cash. the PAR1 ensures the patient's experience is best in class and demonstrates effective communication skills with patients and families, physicians, nurses, and insurance companies. The PAR1 is knowledgeable of and compliant with federal and state regulations related to acute-care patient registration.Responsibilities
Registration Effectively meets customer needs, builds productive customer relationships, and takes responsibility for customer satisfaction and loyalty. Represents the Patient Access department in a professional, courteous manner at ALL times. Asks patients if they may have special needs. Calls patients by name, Greets patients in a courteous and professional manner. Prioritizes and completes registration in a consistent, courteous, professional, accurate and timely manner. Obtains necessary information from patient, including demographic information, insurance, guarantor, and correctly inputs it into registration software. If patient is already in the system, finds correct patient record and verifies information in the system. Uses critical thinking skills to evaluate each registration situation to ensure customized registration experience based on individual patient circumstances. Uses knowledge of federal and state laws (EMTALA, HIPAA, Balanced Billing Act, Participating Provider statute, HITECH law, worker's compensation regulations, victims of sexually oriented criminal offenses regulation, 2 midnight rules, ABN's, Patient status requirements, MSPs, and state regulations on notification of out-of-network status) to ensure compliant registration. Ensures each patient is assigned only one medical record number. Communicates the purpose of and obtains patient/legal guardian signatures on all necessary hospital documents such as Hospital consent forms, assignment of benefits, patient rights, etc. Extensively documents each encounter in account notes to ensure successful cross-function communication. Ensures orders are received and are consistent with tests/procedures. Monitors the waiting room, facilitates patient flow, and resolves issues regarding orders or missing/conflicting information, to ensure timely and accurate patient registration. Insurance and Benefits Knowledge Demonstrates knowledge of insurance plans, including understanding of varying payer rules and requirements related to insurance coverage and prior authorization. Verifies eligibility (utilizing online eligibility software tools whenever possible) and obtains necessary authorizations for services rendered. Selects correct insurance plans in the registration software, in the correct order (primary versus secondary). Has understanding of required forms (including Medicare Secondary Payer Questionnaire) and has ability to explain them to the patient. Utilizes payment estimator software to calculate patient financial responsibility. Uses critical thinking skills to determine correct data input during the estimate process and to verify accuracy of output. Determines when patients may be eligible for financial assistance and directs patients to appropriate resources. Financial Collections Uses proven customer service techniques and scripting to collect the patient financial obligation, at or before the time of service. Negotiates with patient to ensure a deposit is collected, in accordance with corporate policy and procedure. Understands and explains the details of the out-of-pocket calculation. Analyzes documentation/notes on current and previous accounts in order to explain balances to the patient. Demonstrates knowledge and ability to complete account acknowledgement forms when appropriate. Collects cash, prints receipts, and balances cash drawers. Other Duties as Assigned Performs all other duties as assigned. QualificationsExperience: 1-year relevant experience (registration, patient scheduling, customer service, billing, coding, finance, or accounting) in the healthcare industry.License/Cert: Related certification: (Certified Coder, Certified Medical Assistant, or Certified Healthcare Access Associate) or bachelor's degree substitutes for 1 year of experience.Education: High School diploma or equivalent.Special Skills: Advanced clerical and computer skills, critical thinking skills, ability to work in high-stress situations, professional appearance and behavior, good communication skills, dependability, flexibility, teamwork.About UsThe Franciscan Missionaries of Our Lady Health System is a leading health care innovator in Louisiana and Mississippi. We bring together outstanding clinicians, the most advanced technology and leading research to ensure that our patients receive the highest quality and safest care possible.This commitment is grounded in a history that is more than 100 years old, but reflected today by our strategic vision of transforming healthcare through superior performance and excellent patient care.In the last fiscal year, Franciscan Missionaries of Our Lady Health System had:
- 1,747 Licensed Beds
- 65,322 Discharges
- 44,592 OR Procedures
- 10,827 Full Time Employees
- 331,360 Inpatient Days
- 1,915 Active Medical Staff
- 229,296 Emergency Visits
As a nonprofit, mission-focused Catholic healthcare ministry, we give special attention to our citizens who are most in need. During the most recent fiscal year, we provided more than $39 million in unreimbursed care and community support to the underprivileged.Our health system is one of the largest in Louisiana, with hospitals, clinics and physicians located throughout Louisiana and in Mississippi. In fact, we provide care to almost half of Louisiana's citizens, and serve in Mississippi's largest metropolitan area. Because of our size and the partnerships we have with other local organizations, we are able to pool our resources and share cost and service efficiencies and learn from each other, thereby accelerating our ability to improve care and solve challenges.Since our founding in Monroe, Louisiana in 1911, we have been blessed by the guidance of the Franciscan Sisters. Through their guidance and steadfast example, we have committed to assure that we perpetuate their healing ministry for another hundred years. It is a noble purpose we strive to fulfill every day.Headquartered in Baton Rouge, Louisiana, we serve patients across Louisiana and Mississippi through a network of hospitals, clinics, physicians, elderly housing and integrated information system. Our health system has partnered with the State of Louisiana as it transforms its healthcare delivery system. The partnership includes inpatient acute care and primary care delivery in Baton Rouge and Bogalusa.Following in the footsteps of our founders, the Franciscan Missionaries of Our Lady, our team members and physicians are called to provide high quality care and compassion to all people, especially those most in need.As we look to the future of our healthcare ministry, we chart our course by going where we are called.