Patient Account Rep

Overview
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values—integrity, patient-centered, respect, accountability, and compassion—must guide what we do, as individuals and professionals, every day.

Functions as the patient representative and is responsible and accountable for coordinating the
activities of the patient account from the point of scheduling through account resolution. Works with various
scheduling systems and acts as a role model and point person for the registration staff. Formulates solutions to
respond and resolve non-clinical customer requests, issues and problems, while meeting the changing demands
and priorities of the hospital and third party environments. Works closely with the patients, families, outside
departments and third party payers to ensure compliance to individual requirements to expedite the timely
collection of the accounts receivable and protect the patient and the Hospital from unnecessary financial loss.

EEO/AA/Disability/Veteran

Responsibilities

  • 1. Acts as a Patient Representative and works closely with patients and/or family members to insure all demographic and insurance information is accurate and complete while also responding and resolving non-clinical customer requests, issues and problems.
  • 2. Works with the patient and their family to identify and address financial issues, assuming responsibility
    for the patient's account from pre-admission/registration through the account's resolution. Works and
    accurately ensures the completeness of the account based on department benchmarks.
  • 3. Responsible to review and interpret various regulatory programs as they are instituted. Make
    suggestions to operationalize and implement in order to not only ensure compliance to regulations but
    also to protect the patient from unnecessary penalties and financial responsibility.
  • 4. Answers any patient concerns or complaints regarding the admitting, registration, billing and accounts
    receivable process before, during and after services. Refers any non-financial issues to the
    appropriate designated clinical individual and follows up as necessary.
  • 5. Through detailed investigation, identifies potential financial assistance needs and coordinates the
    initiation of payment plans, MedCard applications and inquiry into various state and federally funded
    programs such as Medicaid, Free Care and pharmaceutical programs when appropriate. Ensures the
    application process is initiated as dictated by City, State, and Federal regulations.
  • 6. Coordinates activities of account- Coordinates patient account from point of initial contact
    through account resolution.
  • 7. Coordinates the efforts of the pre-registration, verification, billing and follow up aspects on accounts.
    Serves as the point of contact for the patient and their family on insurance and other financial matters.
    Identifies problems in eligibility for outpatient services and utilizes problem solving skills to ensure
    appropriate follow up and resolution is accomplished.
  • 8. Upon request reviews accounts to ensure all proper authorizations and pre certifications are obtained
    so that appropriate reimbursement is achieved. Acts as a resource for the patient for all insurance
    clearance, verification, billing and reimbursement problems that occur, serving as their liaison to the
    billing and collection process.
  • 9. Ensures appropriate financial documents such as payment agreements, medical releases, advanced
    beneficiary notices and insurance waivers are signed, documented and scanned into the system.
  • 10. Adheres to all SBO standards for the billing and collection of the accounts receivable. Enters all
    financial and demographic data into the computer systems and maintains accurate financial records.
  • 11. Meets with the patient/family to obtain demographic and financial information, inform them of their
    benefits, requests appropriate co-pays, deductibles and coinsurances and obtain appropriate
    signatures to ensure the completeness of the account.
  • 12. Reviews the provider liable denial receivable to identify barriers to the efficient collection of the
    accounts receivable.
  • 13. Promotes Service Excellence- Works with hospital and health system staff throughout the organization to coordinate registration & scheduling in a way that exhibits service excellence and protects the patient and Hospital from unnecessary financial loss.
  • 14. Provides educational information regarding third party requirements to patients, family members and
    other hospital staff as necessary. Maintains department incentives focused on enhancing the patient's
    experience at Greenwich Hospital.
  • 15. Assists in the training and refresher training of new and existing employees.
  • 16. Acts in a leadership role for the registration areas as it relates to scheduling, workflow, authorizations,
    and coverage.
  • 17. Ensures patient satisfaction with the PAR system through identification of opportunities for the
    improving quality of services. Participates in departmental committees which influence or recommend
    policies affecting the admission/registration process. Involved in the identifying and follow through of
    service recovery needs.
  • 18. Uses a variety of software applications, reports and statistical data. Uses available computer systems, such as SDK, On-line Eligibility systems, EPIC, Centricity and others to accomplish tasks and aid in the completion of the account.
  • 19. Confirms eligibility and identifies problems of eligibility for outpatient accounts and other hospital
    services, ensuring that appropriate action is taken to resolve.
  • 20. Researches information as needed to insure all patient demographic and financial information entered
    is accurate and all downstream systems are updated and in sync.

Qualifications

EDUCATION


High School Diploma or General Education Degree (GED


EXPERIENCE


Two to three years in an Access related environment or medical customer relations background. Patient
interviewing and hospital medical insurance and third party experience required.


SPECIAL SKILLS


Must be self directed and well organized with excellent interpersonal and team oriented skills. Strong working
knowledge of computers, word processing & spreadsheet software. Ability to exercise good decision making and
independent judgment. Excellent oral and written communication skills and analytical skills necessary.



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