Admitting - Patient Access Representative PD/Night

JOB SUMMARY: The Patient Access Representative performs all admissions activities for pre-admit and face-to-face registration of patients presenting to the Main Admissions and/or outpatient areas for treatment. Facilitates patient access to Mee Memorial Healthcare System and secures all demographic and financial information. This will include the following: Registration, Preregistration, insurance verification, and securing cash deposits (co-pays, deductibles, cash packages). Able to explain information and answer questions. Demonstrates competency skills including the ability to perform job duties and interact with customers with sensitivity and attention to the patient population(s) served. Coordinates with Patient Experience Associates to support an efficient patient arrival process, including completion of Luma electronic intake forms, and provides assigned telephone and paging coverage as needed. This position supports registration in the Emergency Department (ED), Main Admitting, and other assigned hospital outpatient areas. In the ED, registration processes must not delay medical screening examinations, necessary stabilizing treatment, or appropriate emergency care in accordance with EMTALA and hospital policy.

PERFORMANCE DIMENSIONS AND TASKS
Essential Job Functions
The duties listed below are the essential functions of this position. Employees must be able to perform these essential functions, with or without reasonable accommodation. This list is intended to describe the primary responsibilities of the position and is not intended to be an exhaustive list of all duties. Additional job-related duties may be assigned as needed.
Patient Registration and Identification
• Interviews patients or his/her representative and obtains complete, accurate, personal, demographic and financial information necessary for admission.
• Ensures that all data areas on admit form are complete and accurate; spelling is correct.
• Coordinates with Patient Experience Associates assisting scheduled outpatient surgery and radiology arrivals; completes formal registration, insurance verification, and financial transactions within the Patient Access role.
• Reviews the status of patient-completed electronic intake and registration documents, including Luma forms when applicable; addresses outstanding registration requirements and follows established procedures for documentation and signatures.
• Performs timely and accurate patient registration in the Emergency Department, Main Admitting, and assigned outpatient areas; adapts registration workflow to the clinical urgency and operational needs of each setting.
• Notifies nursing unit of patient ready to admit.
Emergency Department Registration and EMTALA
• For ED arrivals, promptly alerts or coordinates with appropriate clinical staff under established protocols, supports accurate tracking of ED encounters, and obtains essential identifying information without interfering with triage or clinical assessment.
• Follows the Emergency Medical Treatment and Labor Act (EMTALA) and hospital emergency registration procedures. Does not delay or condition a medical screening examination or necessary stabilizing treatment on registration completion, insurance verification, payment, financial screening, or prior authorization; does not discourage patients from remaining for evaluation.
• Completes additional ED demographic, insurance, consent, and financial documentation when clinically appropriate and without delaying care; defers nonurgent registration questions as needed and coordinates follow-up with the care team.
• Maintains accurate ED registration and disposition-related documentation within assigned systems and duties, including patient identification and arrival information; promptly communicates discrepancies or incomplete information to appropriate staff.
• Recognizes and promptly escalates ED arrivals reporting urgent needs or concerns to clinical personnel; does not independently determine clinical priority, provide triage, or decide whether a medical screening examination is required.
Insurance Verification, Authorizations and Financial Counseling
• Verifies insurance coverage.
• Always verifies insurance information
• Obtains prior insurance authorizations within specified period.
• Photocopies insurance cards consistently; obtains signatures at admission.
• May attend to administrative needs of patient/family: (explains charges, alternatives for payment of bill).
• Always responds with sensitivity to patients and family in matters related to money and personal areas.
• Is able to give basic information in response to most questions regarding patient bills/insurance.
• Consistently able to acquire insurance information and reviews with patient to ensure accuracy.
• Ability to process Advance Beneficiary Notices.
Registration Documents, Data Accuracy and Cashiering
• Prepares necessary forms for Medical Records and Patient Accounting.
• Consistently/accurately files all material during assigned shift.
• Performs cashier function as necessary.
• Always follows established MMHS policy for handling cash and collecting money.
• Balances cash box at end of shift.
• Accepts credit cards, using appropriate forms; follows up
• Prepares batching for Data Processing.
• Accurately prepares batching for Data Processing in a timely manner.
• Ability to utilize IT systems in an efficient and effective manner
• Ability to use computer system to verify accounts for return mail.
Telephone, Switchboard and Emergency Communications
• Operates MMHS telephone switchboard.
• Shares responsibility for Main Admitting telephone and switchboard coverage. Answers calls routed to Admitting after the third ring at the Patient Experience Associate desk, and provides primary call coverage when no Patient Experience Associate is scheduled. Routes calls, relays messages, and promptly escalates urgent communications.
• Always answers telephone in a courteous manner.
• Always identifies self and uses correct English and/or Spanish when communicating.
• Always pages in a clear, well-modulated voice to ensure understanding.
• Demonstrates efficient, proper use of radio and paging system.
• Does not use switchboard for personal calls.
• Handles emergency code calls and related paging promptly when assigned to operator or Admitting communication coverage, in accordance with established procedures.
• Initiates or relays authorized emergency code announcements, overhead pages, and drill notifications according to established protocols when assigned operator or backup responsibilities; confirms critical communications and follows downtime procedures.
Daily Worklists, Denials and Account Follow-Up
• Reviews assigned worklist and electronic work queue items daily, including denials, registration errors or corrections, and workers’ compensation accounts requiring follow-up. Investigates outstanding items, takes appropriate corrective action, documents follow-up, and maintains accurate worklist status in accordance with department procedures.
• Reviews and takes action on assigned denial work items within the established three-day turnaround expectation from receipt or assignment, documenting action taken, follow-up needed, and current status.
• Escalates unresolved denials, registration errors, workers’ compensation follow-up issues, or other worklist items to the Patient Access Supervisor or Manager when additional assistance is required or established turnaround expectations cannot be met.
Customer Service, Teamwork and Other Duties
• Is always courteous to clients, in accordance with the MMHS guest relations program; helpful in explaining procedures and administrative policies.
• Performs other job-related duties as assigned.
• Responds to necessary changes in work schedule; uses work time to the department’s advantage by doing various tasks, such as stocking, ordering supplies or special projects.

QUALIFICATIONS

Education
• High School Diploma, GED or equivalent

Licensing
• None

Work Experience
• Previous work experience in an inpatient or outpatient admissions setting or physician's office - Preferred
• Knowledge and/or experience in patient accounting or with an insurance payer - Preferred

Knowledge, Skills and Abilities
• Able to type 40 wpm - Preferred
• Knowledge of office organization and basic clerical skills - Preferred
• Medical terminology - Preferred
• PC literacy: Basic core computer skills and navigation skills.
• General knowledge of office equipment.
• Knowledge of ED registration workflows, EMTALA requirements applicable to nonclinical registration staff, and hospital emergency communication procedures, or ability to learn through training.

Language Requirements
• Bilingual (English/ Spanish) - Required

Physical Requirements
• Must be able to sit up to 6 hours and stand/walk up to 2 hours per day.
• Must be able to push/pull/lift up to 35 pounds.
• Must be able to use hands and feet repetitively for 8 hours or more.

Working Conditions
• Willing to perform repetitive tasks.
• Ability to work with others and to perform a variety of assigned tasks.

DISCLAIMER:
The preceding job description has been designed to indicate the general nature and level of work performed. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.