PATIENT ACCOUNT REPRESENTATIVE
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 responsible and accountable for coordinating the activities of the patient account from the point of initial contact through account resolution. 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.
- 1. ACTS AS A PATIENT REPRESENTATIVE - 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.
- 1.1 Establishes a relationship 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.
- 2. COORDINATES ACTIVITIES OF ACCOUNT - Coordinates patient account from point of initial contact through account resolution.
- 2.1 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 of eligibility for admission, treatment and discharge, and utilizes problem solving skills to ensure appropriate follow up and resolution are accomplished.
- 3. PROMOTES SERVICE EXCELLENCE & THE PAR CONCEPT THROUGHOUT THE ORGANIZATION - Works with hospital and health system staff throughout the organization to coordinate patient admissions in a way that exhibits service excellence and protects the patient and Hospital from unnecessary financial loss
- 3.1 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 Yale New Haven Hospital.
- 4. USES A VARIETY OF SOFTWARE APPLICATIONS, REPORTS AND STATISTICAL DATA - Uses available computer systems, such as SDK, CCSS, On-line Eligibility systems, EPIC, BMD, SCM and others to accomplish tasks and aid in the completion of the account.
- 4.1 Confirms eligibility and identifies problems of eligibility for inpatient admissions and other hospital services, ensuring that appropriate action is taken to resolve.
High School Diploma or General Education Degree (GED)
Two to three years in an Access related environment or medical customer relations background. Patient interviewing and hospital medical insurance and third party experience preferred.
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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