• Patient Access Representative III-Financial Clearance Center

    Job ID
    2018-24494
    Employment Type
    full-time
    Hours Per Week
    40
    Onsite Work Schedule Details
    M - F 9:30 to 6
    Address
    3200 Spring Forest Road
    City
    Raleigh
    State
    NC
  • Overview

    The Patient Access Representative facilitates all components of patient financial clearance by accurately and efficiently handling the day to day operations relating to a patient’s scheduled appointment. This includes obtaining all necessary demographic and financial information to ensure that the most accurate patient data is obtained and populated into the patient record. This role is also responsible for creating a positive patient experience and representing nThrive and partner organizations in a professional manner.

    Responsibilities

    • Interviews patients by phone to obtain all required information for hospital records and billing systems. Pre-registers all scheduled patients for admission, partial hospitalization, and outpatient services according to department policies and procedures.
    • Verifies insurance coverage and obtains authorization for all services requiring pre-certification.
    • Performs clerical functions as needed, including answering phones, taking messages, chart processing, faxing and scanning.
    • Collects and processes upfront deposits or set up payment arrangements, as required.
    • Screens patient for Medicaid, Affordable care Act or hospital sponsored financial program and provides appropriate documentation and referral.
    • Assists team with escalated issues, trains other team members as needed and is a subject matter expert.
    • Adheres to department policies and procedures related to verification of eligibility, benefits, pre-authorization requirements, available payment options, financial counseling and other identified financial clearance related duties.
    • The Patient Access Representative III is expected to develop a thorough understanding of assigned functions to include complex financial clearance of scheduled appointments.
    • Understand and maintain operations knowledge of Medicare and other state and federal government payor compliance requirements for the population served.
    • Supports nThrive’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to nThrive’s business practices. This includes: becoming familiar with nThrive’s Code of Ethics, attending training as required, notifying management or nThrive’s Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations.

     

    Qualifications

    • High school diploma or equivalent
    • At least 3 years of experience working in a role within a customer-facing, fast paced environment with high volume of either calls or in-person requests.
    • At least 3 years of experience working within the registration process in a hospital or physician office setting, including demonstrated success obtaining patient demographic and financial information, handling insurance verification, obtaining authorizations and financial counseling.
    • Expert knowledge of patient access services and the overall effect on the revenue cycle.
    • A thorough understanding of commercial and government insurance plans, payer networks, government resources and medical terminology.
    • Experience communicating effectively with a customer and simplifying complex information.
    • Ability to navigate Internet Explorer and Microsoft Office.
    • Experience working in a role that requires prioritization of multiple critical priorities while ensuring quality and achievement of performance metrics.
    • Demonstrated ability to meet or exceed performance metrics.
    • Meet or exceed established productivity, quality and revenue metrics.
    • Ability to handle sensitive information and maintain HIPAA compliance

    About nThrive

    Be Inspired. Ignite Change. Transform Health Care. 

    From Patient-to-PaymentSM, nThrive provides all the technology, advisory expertise, services, analytics and education programs health care organizations need to thrive in the communities they serve. Our colleagues share a united passion to help health care organizations strengthen their financial position, which translates to accessible, quality care for all. This passion fuels our drive to innovate and participate in community outreach through the nThrive CARES program. Our colleagues are encouraged to think differently and empowered to make a lasting impact that ensures our health care providers, and our world, are healthy and productive.

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