Patient Access Representative
Indexed description
Primary Responsibilities
- Performs insurance verification duties to financially clear the patient in advance of date of service
- Verifies healthcare coverage and benefits for applicable services, working with the patient, provider, and payer to ensure accurate information and needs are met in advance of service
- Ensures excellent customer service when assisting patients, providers, and other departments
- Collects and updates patient demographic and insurance information, making changes as necessary to ensure accuracy with insurance benefits, referrals, and authorizations
- Verifies precertification / authorizations for scheduled services utilizing internet sites, payer contacts, and software as appropriate
- Assesses coverage and benefits, and accurately determines patient responsibility as applicable
- Identifies self-pay patients and shares information with financial counseling for assistance with patient financial obligation and options
- Partners closely with the clinical, office, billing, and registration teams and works to review authorizations timely, as applicable
- Appropriately documents all conversations with insurance companies and health care facilities that pertain to the authorizations or payment of services
- Escalates questions or concerns to leadership as needed
- Maintains and exhibits a current knowledge of insurance plans, associated workflows and information, and the impact of this role within the revenue cycle
- Remains aware of department productivity expectations, and other measurable performance data and meets / exceeds individual contributions to the team performance
- Strives to maximize revenue and minimize bad debt
- Maintains a safe environment complying with NLH policies and procedures; reports and directly addresses environmental hazards and violations of patient safety policy and / or protocol when involved or observed
- May perform other duties upon request
Required Qualifications
- High School Diploma/GED
- 6+ months of experience in an office setting, customer service setting (over the phone OR face to face), phone support role or call center environment
- Intermediate level of proficiency with Microsoft Office products
- Influenza vaccination for the current flu season (typically August-May) or commitment to receive the influenza vaccination when available for the upcoming flu season
- Ability to work Monday - Friday from 8:00am - 4:30pm
- 1+ years of Patient Access experience in a hospital OR medical setting
- Prior experience working an overnight schedule
- Understanding of medical terminology
- Working knowledge of insurance policies, procedures and patient care settings
- PLEASE NOTE** The sign-on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#RED, #RPO
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