Patient Access Representative - Nelson Clinic - Ophthalmology - Days

Greet Patients/Answer Telephone 
Provides exceptional customer service by welcoming patients and visitors in a friendly, professional, and respectful manner.  Ensures individuals are respected and informed, communicating clearly and effectively, and utilizing appropriate language resources as needed.  Assists with traffic flow in and out of the clinic as needed.  Addresses patient needs promptly, and maintains a courteous, professional tone at all times.   

Co-payment Collection & Registration Data 
Collects all patient co-payments and deposits accurately per payer, following department guidelines.  Verifies and updates registration data, including demographic and insurance information. Copies and records insurance information per department standards. Follows department policies for cash handling, including cash reconciliation and deposit preparation.    

Referral Management  

Verifies insurance coverage and understands requirements for HMO, managed care, government and private plans. Secures required referrals/authorizations and links them correctly in the referral module. Obtains needed referrals and authorizations before scheduled procedures, tests, injections and surgeries. Communicates plan-specific referral/authorization requirements to patients and providers.  Provides pre-payment guidance for self-pay patients and offers financial assistance. Prepares cost estimates, explains payment expectations and documents all interactions in the patient account.    

Appointment Scheduling, Lab & Test Order Entry 
Correctly schedules clinic appointments through the medical records software/communication platform. Transcribes physician orders accurately and completely (i.e. lab test, ancillary test) and records them in the appropriate system(s) according to the physician’s instructions and VCUHS policy. Coordinates the collection of pre-operative testing and paperwork, where appropriate. 

Patient Record/Verify Registration Data 
Maintains proficiency in all aspects of patient medical record keeping in an organized manner. Assists in preparation of the chart before the patient visits. If applicable, assists in breaking down the chart at the completion of the patient's visit. Ensures that all patients arrived in the appointment scheduling system before the end of the appointment day. Where appropriate, appointments are documented as “no-shows” or cancellations before the end of the appointment day. Obtains signatures and completes the required forms including those from managed care and other insurance plans. 

E-Documents Management & Scanning 
Obtains and scans all appropriate patient medical documentation. 

Miscellaneous Responsibilities 

Education Preferred: Associates or Bachelor’s Degree in Accounting, Finance, Business Administration, Healthcare Administration or closely related field from an accredited program. 

Licensing/ Certification

Licensure Required: N/A 

Licensure Preferred: N/A  

Certification Required: N/A 

Certification Preferred: N/A 

Minimum Qualifications 

Years and Type of Required Experience: 

Demonstrated experience using computers, Microsoft Office applications, and web-based platforms 

 Experience Preferred: Work experience with medical insurance, HMO, managed care, electronic medical billing/order entry/registration systems, and appointment scheduling. 

 Previous work experience in a healthcare setting, and  knowledge of medical terminology. 

Other Knowledge, Skills and Abilities Required: Able to perform daily activities with minimal supervision: being self-directed in the accomplishment of routine activities. 

Other Knowledge, Skills and Abilities Preferred: Depending on assignment, may be required to work off-shifts and/or weekend and holidays.  

Working Conditions: Periods of high stress and fluctuating workloads may occur. General office environment. May have periods of constant interruptions. Prolonged periods of working alone.  

Physical Requirements 

Physical Demands: Lifting/ Carrying (0-50 lbs.), Push/ Pull (0-50 lbs.), Stoop, Kneel, Squat, Crawling, Climbing, Balance, Bending 

Work Position: Sitting, Walking, Standing

Additional Physical Requirements/ Hazards  

Mental/Sensory: Strong Recall, Reasoning, Problem Solving, Hearing, Speak Clearly, Reading, Logical Thinking

Emotional : Fast pace environment, Able to Handle Multiple Priorities, Frequent and Intense Customer Interactions, Able to Adapt to Frequent Change