Patient Access Associate I

Under general supervision, coordinates and performs a variety of administrative, registration and financial support duties for the unit/department. Utilizes judgment to interpret department policies to resolve routine inquiries/problems.  Identifies opportunities for process improvements.  Performs all duties in a manner that promotes a team concept and reflects the mission, behaviors, core values and philosophy of CT Children’s.

Following department protocol provides general receptionist, secretarial support or Health Unit Coordinator functions.  
Performs a variety of administrative support activities in support of the unit operations. Responds with tact and discretion to the needs of patients and families.  Maintains privacy and confidentiality by abiding by HIPPA Policies.

Registration:

• Collects and enters accurate demographic, guarantor and financial data for Emergency Department, Inpatient and Outpatient cases and Physician Practice Office appointments. 
• Verifies all required insurance and billing information and uses the proper payer plan codes. 
• Generates all necessary forms for patient visit and obtains patient/parent/legal guardian signature for Assignment/ Authorization and consent. 
• Performs pre-registration for scheduled patients and registers patients adhering to standard department procedure.  
• Makes corrections and updates patient information in ADT systems as necessary. 
• Asks patients/families whether their visit was satisfactory and attempts to address any questions/issues prior to patient departure.
• Attempts to collect the patient liability, co-payment on all accounts at the designated collection point.
• Documents thorough, clear, explanatory notes regarding reasons for incomplete information at time of registration and documents insurance verification method along with response. Documents concise and understandable comments regarding patient or guarantor interaction, efforts to collect co-payments and referrals to Financial Counseling.
• Follows-up on open items to resolve outstanding issues and complete the file.
• Reviews and works assigned work queues for registration information to ensure that accounts are accurate at time of visit and or billing.

Scheduling:

• Schedule routine appointments either in person or via telephone.
• Creates/inputs routine department provider appointments.
• May schedule/coordinate appointments with other areas of the hospital.
• Works directly with DCF to obtain appropriate signatures/legal guardian information.
• As a first line representative of CT Children’s, this person must have the ability to deal compassionately and professionally with patients and families.
  Front Office (Check-In):
• Arrives patients for their appointment in the ADT system.
• Verifies demographic and insurance information at time of arrival (including securing patient financial liability at time of service).
• Check out process including scheduling or rescheduling future appointments.
• Answers telephone and triage calls for the department.
• Ensure all consent and privacy forms are signed.
• Works directly with DCF to obtain appropriate signatures/legal guardian information.
• Enters routine to complex patient charges into billing system for physician or care provider visits, according to protocol.
• Attempts to collect the patient liability, co-payment on all accounts at the designated collection point.
• Other front office duties as required.

Front Office (Check-In):

• Arrives patients for their appointment in the ADT system.
• Verifies demographic and insurance information at time of arrival (including securing patient financial liability at time of service).
• Check out process including scheduling or rescheduling future appointments.
• Answers telephone and triage calls for the department.
• Ensure all consent and privacy forms are signed.
• Works directly with DCF to obtain appropriate signatures/legal guardian information.
• Enters routine to complex patient charges into billing system for physician or care provider visits, according to protocol.
• Attempts to collect the patient liability, co-payment on all accounts at the designated collection point.
• Other front office duties as required.

Financial:

• Verifies insurance plans using the various methods available such as, RTE, web-based, & telecommunications. 
• Investigates patient insurance coverage, obtains referrals, and manages process to maximize payment from both commercial and managed care plans. 
• Refers patients/ families to DSS and/or Financial Counselor for assistance.
• Post payments in ADT system, provide receipts. 
• Identifies those patients without adequate insurance coverage.
• Demonstrates knowledge of the age-related differences and needs of patients in appropriate, specific populations from neonate through adolescence and applies them to practice. 
• Demonstrates cultural sensitivity in all interactions with patients/families.  
• Demonstrates support for the mission, values and goals of the organization through behaviors that are consistent with the CT Children’s standards.
   

Education and/or Experience:

• Education Required: High School Diploma, GED, or a higher level of education that would require the completion of high school, is required. 
• Experience Required: 3-5 years directly related customer service experience required.

Education and/or Experience Preferred:

• Education Preferred: Associate's degree preferred.
• Experience Preferred: Healthcare experience preferred.

Knowledge, Skills and Abilities:

Knowledge of:

• Working knowledge of MS Word and Excel.
• ADT systems and Insurance Verification systems (EPIC preferred).
• Knowledge of Managed Care, referral/pre-certification/ authorization process.
• HIPAA

Skills:

• Computer, typing, data entry.
• Excellent telephone and communication skills

Ability to:

• Handle a fast-paced, high-volume environment.
• Work in a team environment alongside multiple disciplines.