PATIENT ACCESS ASSOCIATE II

The Patient Access Associate II for the Cardiac Specialists department at Riverside Healthcare is responsible for managing patient registration, scheduling, and insurance compliance in a fast-paced environment. This role involves interacting compassionately with patients and their representatives, ensuring a thorough understanding of revenue cycle expectations and payment options. The Associate will handle the accurate collection and recording of demographic, insurance, and clinical data, screen for compliance with payer requirements, and provide exceptional customer service throughout the patient access process.

Essential Duties

•  Patient Registration and Scheduling:
• Accurately collect, analyze, and record all necessary demographic, insurance/financial, and clinical data for patient scheduling, pre-registration, and registration.
• Coordinate and schedule patient appointments, considering clinical urgency, procedural conflicts, and patient and physician preferences.
• Optimize patient schedules to ensure convenience and continuity of care, and pre-register appointments whenever possible.
• Insurance and Compliance:
• Verify third-party eligibility and benefits, ensuring compliance with payer requirements for medical necessity and precertification.
• Accurately process and document financial information and patient responsibilities, explaining payer policies and financial expectations clearly to patients.
• Review and analyze patient records to identify discrepancies, reverify payor information, and ensure accurate documentation of medical necessity.
• Customer Service:
• Interact with patients, their representatives, and internal and external entities with a focus on customer satisfaction and compassionate service.
• Provide clear preparation instructions for tests/procedures and guide patients to the appropriate treatment sites.
• Respond to and manage telephone, electronic, and in-person inquiries, ensuring accurate information and resolution of issues.
• Data Entry and Documentation:
• Electronically record and manage information in a timely and accurate manner, maintaining confidentiality and adhering to HIPAA regulations.
• Maintain and organize reference materials, both financial and clinical, and perform accurate data entry for charges and documentation.
• Compliance and Reporting:
• Follow EMTALA, HIPAA, and payer regulations for registration and scheduling.
• Review and assess departmental workflow and make necessary adjustments to meet volume needs and ensure timely responses.
• Attend mandatory continuing education and department meetings to stay updated on policies and procedures.
• Additional Duties:
• Perform courier services between the AIC and main hospital campus as required.
• Assist with maintaining departmental supplies and files, ensuring all necessary materials are available and organized.\"

Non-essential Duties

• Support other administrative tasks and projects as assigned by the supervisor.
• Participate in departmental initiatives and process improvements to enhance patient access services.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our Commitment to You:

Riverside Healthcare offers a comprehensive suite of Total Rewards: benefits and nationally rated employee well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so your journey at and away from work is remarkable.  Our Total Rewards package includes:

Compensation

• Base compensation within the position’s pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift differential, on-call
• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Health Savings and Flexible Spending Accounts for eligible health care and dependent care expenses
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

Preferred Experience

• Experience:
• Prior call center experience preferred.
• Knowledge of medical terminology and experience in office or clerical roles preferred.
• Understanding of hospital revenue cycle, payer regulatory compliance, and HIPAA Privacy and Security requirements.
• Skills:
• Strong customer service skills with the ability to communicate effectively and compassionately.
• Detail-oriented with a commitment to accuracy and problem-solving.
• Proficient in general arithmetic and computer literacy, with the ability to learn new software applications.
• Ability to work independently and manage multiple tasks in a fast-paced environment.

Required Licensure/Education

• High School Diploma or equivalent required.

Preferred Education

• Associate Degree preferred.

Employee Health Requirements

Exposure/Sensory Requirements:

Exposure to: 

• Chemicals: None
• Video Display Terminals: Average
• Blood and Body Fluids: Performing ER and Admitting registrations have the potential to be exposed.
• TB or Airborne Pathogens: Performing ER and Admitting registrations have the potential to be exposed.

Sensory requirements (speech, vision, smell, hearing, touch):

• Speech: Required to communicate during presentations/training, telephone communication, and facilitate meetings.
• Vision: Needed to read memos and literature, close vision (ability to adjust focus).
• Smell: NA
• Hearing: Needed for telephone communication, meetings, alarms and listening to employee concerns.
• Touch: Needed to write, computer entry, filing.

Activity/Lifting Requirements:

Percentage of time during the normal workday the employee is required to:

• Sit: 50-88%
• Twist: 5%
• Stand: 1%
• Crawl: 0%
• Walk: 12-50%
• Kneel: 0%
• Lift: 0%
• Drive: 0%
• Squat: 0%
• Climb: 0%
• Bend: 5%
• Reach above shoulders: 2%

The weight required to be lifted each normal workday according to the continuum described below:

• Up to 10 lbs: Frequently  
• Up to 20 lbs: Frequently
• Up to 35 lbs: Occasionally
• Up to 50 lbs: Occasionally
• Up to 75 lbs: Not Required
• Up to 100 lbs: Not Required
• Over 100 lbs: Not Required

Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.): Carrying materials such as charts and labels waist high and for approximately 20 feet.

Maximum consecutive time (minutes) during the normal workday for each activity:

• Sit: 30
• Twist: 1
• Stand: 5
• Crawl: 0
• Walk: 5
• Kneel: 0
• Lift: 0
• Drive: 0
• Squat: 0
• Climb: 0
• Bend: 0
• Reach above shoulders: 1

Repetitive use of hands (Frequency indicated):

• Simple grasp up to 10 lbs. 
• Normal weight: 5- 10# frequent
• Pushing &pulling Normal weight: <50#>
• Fine Manipulation: Computer keyboard, writing, calculator.

Repetitive use of foot or feet in operating machine control: Not Required

Environmental Factors & Special Hazards:

Environmental Factors (Time Spent):

• Inside hours: 8
• Outside hours : 0
• Temperature: Normal Range
• Lighting: Average
• Noise levels: Average
• Humidity: Normal Range
• Atmosphere:

Special Hazards:

Protective Clothing Required: None