Patient Access Representative

• Perform insurance verification and authorization functions supporting Patient Access Services
• Complete authorization initiation requests with payers for acute and ambulatory visits
• Validate existing provider-requested authorizations
• Use authorization submission tools, payer websites, documents, and Host systems
• Provide authorization numbers and patient demographic information to billing and other appropriate staff
• Explain referral processes to physicians and staff
• Document and maintain referral and authorization records
• Refer encounters for peer review to substantiate ordered procedures
• Respond to provider orders for tests, procedures, and specialty visits
• Obtain authorizations for single and recurring visits, verifying demographics, codes, service dates, and clinical data
• Stay current on payer requirements and use third-party authorization submission software
• Work independently from a remote location using structured work routines
• Prioritize work and ensure appropriateness and timeliness of patient care
• Escalate accounts that do not meet authorization standards and coordinate resolution with providers, scheduling departments, PAS leaders, and administrative groups
• Perform related duties, including cross-coverage in other authorization-related areas

Patient Access Services Authorization Representative

• Link the patient experience between PACT and the practice site using facility/provider information and established procedures
• Assist inbound callers using available resources and critical thinking; make outbound calls when needed
• Recognize complex problems and escalate them for resolution
• Perform basic technical troubleshooting for online applications, systems, or access issues
• Schedule patient appointments and coordinate cancellations, reschedules, and additions to schedules
• Obtain demographic and insurance information and verify insurance coverage
• Complete forms and verify and update medical records
• Identify emergent calls and immediately transfer them to a Registered Nurse for triage
• Route patients for triage, scheduling, rescheduling, and appointment cancellations
• Submit medication refill requests and page providers and facilities as appropriate
• Provide customer service according to departmental standards
• Support organizational marketing efforts by providing information and referrals
• Maintain records and regularly report on and update provider and marketing databases
• Maintain knowledge and efficient use of departmental information systems
• Perform additional duties based on department needs

Patient Access & Care Team Representative I

• Greet customers and facilitate the patient registration process
• Interview patients or representatives to obtain demographic and financial information
• Provide documents and data for appropriate care and compliant, accurate registration and billing
• Liaise between patients, Virtual Patient Registration Representatives, and Patient Schedulers
• Complete patient checkout
• Schedule follow-up appointments according to physician orders
• Provide cost estimates and itineraries for upcoming appointments
• Obtain insurance cards and identification and update medical records
• Perform point-of-service data collection and collect co-payments and down payments
• Reconcile the cash drawer and report daily deposit records
• Maintain assigned work queues
• Provide courteous customer service
• Answer incoming calls and refer patients to the clinical team as needed
• Sanitize registration equipment and restock supplies
• Perform other clerical duties as assigned

• Work part-time on the day shift, 0700–1530, every other Saturday
• Research, collect, and analyze information
• Identify opportunities, develop solutions, and lead through resolution
• Collaborate on performance improvement activities based on program efficiency and patient experience outcomes
• Distribute analytical reports
• Utilize multiple system applications to perform analysis, create reports, and develop educational materials
• Apply knowledge of Trinity Health policies, practices, and processes to prioritize quality, confidentiality, and safety
• Research and compile information for ad-hoc operational projects and initiatives
• Synthesize and analyze data, provide detailed summaries, and present graphical data illustrating trends
• Recommend practical options or solutions while considering business strategy and supporting leadership decision-making
• Leverage program and operational data and measurements to define and demonstrate progress, ROI, and impacts
• Maintain knowledge of applicable laws, regulations, compliance requirements, policies, procedures, and guidelines

Part Time Patient Access Representative

• Serve as the first point of contact for patients
• Facilitate general appointment and escalation appointment scheduling
• Register new patients and review existing patient demographics
• Verify and update insurance information
• Answer general patient questions
• Prepare patient messages for providers, triage, surgical scheduling and other internal departments
• Handle inbound calls for a high-volume practice while working remotely
• Accurately document patient requests and concerns in EPIC EMR
• Resolve patient inquiries and concerns and appropriately escalate emergent concerns
• Perform other duties as assigned
• Use standard office equipment including computers, phones and faxing through RingCentral

• Register patients presenting for visits and explain the registration process
• Process patient payments, safeguard funds, reconcile the cash drawer, and assist with kiosk check-in
• Complete Medicare Secondary Payer Questionnaires and adjust coverage
• Obtain signatures and process consent, financial, and clinical documents
• Counsel patients regarding non-covered services, ABNs, consents, and waivers
• Monitor the patient waiting area and support an efficient registration flow
• Respond to patient concerns and potential safety issues
• Maintain an orderly registration area and secure confidential information
• Schedule, reschedule, and cancel appointments using calls, digital messages, orders, work queues, questionnaires, and searches
• Apply clinical department scheduling protocols and escalate issues when necessary
• Capture and verify scheduling and registration information, including physician, insurance, demographic, and contact details
• Communicate appointment and patient-care issues to Patient Access management
• Follow confidentiality and equipment-security guidelines when working remotely and maintain productivity, quality, and accuracy
• Register patients for pre-registration, assign guarantors, verify insurance eligibility, apply coverage, and communicate financial clearance status
• Advise patients regarding contract status, self-pay status, payment responsibility, and financial counseling

Patient Access Representative, Scheduling

• Perform financial clearance, registration, and clerical duties associated with point-of-service services in the Imaging department
• Meet with patients or caregivers to exchange necessary information and documentation
• Explain processes and address concerns and questions
• Communicate with unit staff and other appropriate personnel to exchange information and determine placement
• Verify insurance benefits and obtain precertification/authorization
• Ensure verification of medical necessity as necessary
• Determine and accept required payments, including co-pays, deductibles, and coinsurance, or refer patients to financial counselors
• Obtain and accurately enter demographic, billing, and clinical information into the registration system

Patient Access Representative – Imaging Department

• Request and obtain prescriptions and authorizations from medical offices and insurance companies
• Follow up with providers and payers to ensure timely receipt of required documentation
• Resolve questions related to Certificates of Medical Necessity (CMN) and participating provider requirements
• Re-verify patient eligibility for ongoing services
• Maintain accurate, compliant documentation in accordance with HIPAA and regulatory standards
• Communicate with patients, provider offices, and internal teams to resolve access-related issues
• Maintain an organized office environment
• Monitor enteral formula storage temperatures per safety standards
• Conduct routine safety checks, including fire extinguisher inspections
• Manage inventory of supplies and equipment
• Maintain clean and dirty equipment areas per health protocols
• Assist customers, vendors, and surveyors during visits

• Request and obtain prescriptions and authorizations from medical offices and insurance companies
• Follow up with providers and payers to ensure timely receipt of required documentation
• Resolve questions related to Certificates of Medical Necessity (CMN) and participating provider requirements
• Re-verify patient eligibility for ongoing services
• Maintain accurate, compliant documentation in accordance with HIPAA and regulatory standards
• Communicate with patients, provider offices, and internal teams to resolve access-related issues

• Obtain registration information, insurance information and verification, and authorizations from new and established patients
• Screen, schedule, and direct patients to appropriate providers and services
• Convey a positive image of Carle and provide information to patients about Carle services by telephone and face-to-face
• Check patients in upon arrival for scheduled appointments
• Facilitate upfront collection of co-payments
• Accurately explain and complete registration and admitting forms
• Obtain signatures from patients and policyholders
• Explain and obtain signatures for Consents, Assignment of Benefits, ABN's, and Notice of Non Coverage forms
• Perform cash drawer management and co-pay collections
• Request, locate, send, and receive patient medical records as needed
• Receive incoming telephone calls
• Check patients out promptly and courteously
• Adhere to and enforce Carle policies and procedures
• Attend meetings to enhance knowledge
• Perform other duties as assigned
• Suggest ways to improve processes