Patient Access Representative Resume Sample
Demarco Pfeffer
7360 Idell Inlet,
Phoenix,
AZ
+1 (555) 968 5561
Work Experience
Associate Patient Access Representative
06/2017
-
PRESENT
Phoenix, AZ
- Communicate to the patient the Northwest’s policy on payment of services or prepayment when significant patient liabilities are identified
- Refers, as appropriate, to financial counselors
- Interacts with Patient Business Services/Membership Services personnel regarding status of accounts as necessary to respond to questions/concerns related to registration requirements
- Documents all activity pertaining to patient's account in the system
- Completes regulatory or policy required forms, to include payor requirements such as Medicare, L & I requirements & some commercial payors, & obtains all necessary signatures via mail, pre-admit, pre-op visit or upon admission/ registration
- Makes copies of patient identification, insurance information & other related forms & documents, electronically scan capture where appropriate
- Understands & adheres to the rules & regulations of Medicare, Medicaid, Managed Care & Commercial payers regarding referrals, preauthorization & pre-certification requirements
- Is knowledgeable & maintains compliance with CMS by accurately completing Medicare Secondary Payer screening information to determine primary payor
Patient Access Representative
10/2013
-
01/2017
San Francisco, CA
- Receives physician orders and, if applicable, performs medical necessity check using automated system
- Interprets basic healthcare system’s regulations & policies for patients & patient families consistent with the defined scope of work
- Knowledge of MOAB training requirements for managing aggressive behavior
- Maintains an understanding of HIPAA privacy & security regulations with respect to Patient confidentiality & regulations that govern system use for patient registration requirements
- Understands & adheres to EMTALA regulations & the relevance for patient registration & patient liability collection in the Emergency Department
- Demonstrated working knowledge of software/system/equipment/PCs
- Understand the Authorization Policy and works with leadership and physician’s office to determine if the patient’s procedure is urgent/emergent for possible service deferral
Patient Access Representative With Benefits Days & Evenings
05/2007
-
05/2013
Phoenix, AZ
- Close cash drawers and make deposits
- Facilitates cross-functional resolution of drug coverage issues
- Demonstrates/models the Network’s Service Excellence Standards of Performance in interactions with all customers (internal and external)
- Demonstrate Performance Improvement in the following areas as appropriate: Clinical Care/Outcomes, Customer/Service Improvement, Operational System/Process, and Safety
- Demonstrate financial responsibility and accountability through the effective and efficient use of resources in daily procedures, processes and practices
- Demonstrate competency with Downtime procedures in Epic, and ancillary systems
- Demonstrate and models the hospital’s core values and customer service behaviors in interactions with all customers (internal and external)
- Demonstrate and models the hospital’s core values and customer service behaviors in interactions with all customers (internal and external).
- Am - 3:30pm 4 days
Education
The Ohio State University
2002 - 2006
School's Degree in Related Area Desired
Professional Skills
- Experience / Knowledge / Skills: Prior experience in a business office or customer service setting
- Computer skills: Word, Excel, 10-key by touch, basic English and Mathematical skills. Typing 35 WPM
- Demonstrates technical accuracy, excellent communication skills and the highest ethical standards
- Excellent communication and interpersonal skills on the telephone and in person
- Demonstrated advanced computer skills with various software programs, such as Microsoft Outlook, Word, Excel and other department specific programs
- Prior experience in patient access, billing, cash collections, insurance, appointment scheduling or directly related experience in a health care environment
- Computer/PC experience/skills are required
How to write Patient Access Representative Resume
Patient Access Representative role is responsible for customer, computer, patient, interpersonal, general, basic, medical, organizational, payer, typing.
To write great resume for patient access representative job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Patient Access Representative Resume
The section contact information is important in your patient access representative resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Patient Access Representative Resume
The section work experience is an essential part of your patient access representative resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous patient access representative responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular patient access representative position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Patient Access Representative resume experience can include:
- Excellent critical thinking skills with the ability to independently resolve problems
- Experience communicating effectively with a customer and simplifying complex information
- Excellent customer service, verbal communication and interpersonal skills required
- Demonstrates initiative and skill in planning and organizing work, and paying close attention to detail
- Performs medical /pharmacy benefit verification requiring complex decision skills based on payer and process knowledge
- Intermediate data entry skills, working knowledge of Microsoft Office and Patient Access knowledge
Education on a Patient Access Representative Resume
Make sure to make education a priority on your patient access representative resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your patient access representative experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Patient Access Representative Resume
When listing skills on your patient access representative resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical patient access representative skills:
- Strong computer skills, critical thinking skills and the ability to multitask in a fast paced work environment are required
- Demonstrated experience communicating effectively with a customer, simplifying complex information and handling escalated customer issues
- Experience / Knowledge / Skills: Three years of experience in a hospital or medical business office setting
- Good communication skills, detail oriented, multi-tasking, telephone experience, computer, fax, copiers, and general office equipment
- One (1) year of experience in a healthcare or customer service setting with proven customer service skills
- Strong clerical and organizational skills
List of Typical Experience For a Patient Access Representative Resume
1
Experience For Associate Patient Access Representative Resume
- Good organization and time management skills are needed
- Scheduling skills adaptable to a fast pace environment with heavy physician/physician office staff interaction
- Physical dexterity and psychomotor skills to respond adequately and appropriately to routine and emergent patient care needs in an ambulatory setting
- Demonstrate financial responsibility and accountability through the effective and efficient use of resources in daily procedures, processes, and practices
- Communicate effectively with physicians’ offices, staff, patients and their families
- Microsoft Excel/Word skills
- Able to communicate effectively with patient at bedside/booth for up-front collection
- Prior experience with hospital registration & knowledge of insurance benefits necessary
- Experience working in a role within a customer-facing, fast paced environment with high volume of either phone calls or in person requests
2
Experience For Patient Access Representative Days Resume
- Demonstrates the importance of quality and integrity of capturing patient information with regards to patient confidentiality.
- Collects patient portion from patients prior to or at time of service (following MSE).
- Demonstrate efficiency and familiarity with hospital systems including
- One (1) year experience with coding: ICD-9, CPT, HCPCS
- The position requires continuous training to upgrade skill set to support transformation and sustainability
- Demonstrate and models the hospital’s core values and customer service behaviors in interactions with all customers (internal and external).
- Demonstrates the ability to multi-task and work independently with minimal supervision
3
Experience For Patient Access Representative 7pm to 7am Resume
- Greets/interviews new patients and discusses co-payments, prior authorization requirements
- Knowledge of patient financial clearance for the professional component prior to the office
- Demonstrate efficiency and familiarity with hospital systems in order to complete the registration process and financially secure the patient’s visit
- Demonstrate efficiency and familiarity with hospital systems
- Previous hospital or clinic registration experience
- Demonstrate efficiency and familiarity with all Epic applications responsible to complete functions of the position
- Experience with high volume in person and phone patient customer service in a fast paced environment
4
Experience For Patient Access Representative With Benefits 12pm to 5pm Resume
- Secures all required prior authorizations for all Neurology, Cardiology, High end Radiology, Pain injections and surgery. Works denials when needed
- Operates office equipment such as computer, printer and photocopier
- Demonstrates the ability to multi-task and work independently with minimalsupervision
- Demonstrates respect and cooperation in all staff relationships, and a genuine willingness to prevent or resolve inter-personal conflicts
- One (1) year patient third party eligibility verification experience on an automated patient accounts system
- Experience with data-entry and computer software programs such as Microsoft Word and Excel
5
Experience For Patient Access Representative M-F 11am to 8pm Resume
- Customer service, retail, call center or hospitality work experience
- Work experience in a multi-provider practice
- General knowledge of health insurance and business experience. Knowledge of clinical terms required
- Two years of experience in a hospital or medical business office setting
- Accountable for multiple scopes of service as assigned. Serves as preceptor, mentor, and resource to less experienced staff
- Understanding of hospital collections
- Collecting CO-Pay information
- Primarily works inside with frequent sitting, walking, standing, bending and occasional lifting of supplies not in excess of 25 pounds
- Responsible for interviewing/registering/instructing patients in a face-to-face setting or on the telephone
6
Experience For Patient Access Representative With Benefits Days & Evenings Resume
- Physical Demands Light-lifting 20 lbs maximum with frequent lifting/carrying up to 10 lbs General office environment, non-smoking, moderate noise level
- Participates in staff training to increase understanding of specific payer requirements, scheduling protocols and general functionality
- Provide general clerical support, including filing, scanning, and coordination of release of medical records
- Provides expert assistance to clients on patient status; Acts as liaison for company providing referral status reporting
- Uses discretion and independent judgment in handling patient or complex client complaints, escalating as appropriate
- Liaison for company providing referral status reporting
- Use discretion & independent judgment in handling pt or more complex client complaints, escalating as appropriate
7
Experience For Patient Access Representative Overnight Resume
- Collaborates with Security Department the accuracy in documenting and verifying patient valuables
- Serves as a liaison for all correspondence and inquires pertaining to billing issues
- Create, maintain and ensure accuracy of medical record keeping by verifying that lab results are reviewed
- Cashier functions including multiple pricing schedules and credit card transactions and reconciliation
- Work weeks are based off 40 hours (8 hour days) with various scheduled hours ranging from 6am-10pm with primary work hours being 8am-5pm
8
Experience For Patient Access Representative 8am to 8pm Thurs Fri Sat Resume
- Responsible for follow-up communication regarding insurance/authorization status to physicians, clinicians and billing teams
- Responsible for ensuring that all authorization and tracking processes for the practice are compliant within the agreed client and practice guidelines
- Previous patient registration, cashiering, knowledge of insurance verification authorization and billing process
- Exhibits responsibility for professional development and maintaining required clinical knowledge, training and credentials
- Prepares patient for exam, explaining any procedures before they are performed and answering the patients' questions
- Read and write the English language following the rules of grammar and spelling
9
Experience For Patient Access Representative IV Resume
- Facilitates cross-functional resolution of drug coverage issues & proactively addresses, researches & resolves issues impacting revenue optimization
- Ensures that all necessary demographic, billing and clinical information is obtained and enteed with timeliness and accuracy
- Communicates with physicians's and their staff, nursing unit staff, and/or other approrpirate personnel to exchange necessary information
- Determines and accepts required payments, including but not linited to co-pays and deductibles
- Determines and accepts required payments, including but not linited to co-pays and deductibles.
10
Experience For Patient Access Representative PRN Resume
- Assist patients with on site customer service functions (e.g., billing, medical records and
- Check for physician orders and attaches them to patient medical record to ensure that patients are receiving appropriate tests
- Choose correct health plan and accurately and research to ensure accuracy when verifying insurance
- Receives new insurance information on existing patients and enters into PRISM System
- Assists patients with questions and/or problems regarding insurance referrals, authorizations
List of Typical Skills For a Patient Access Representative Resume
1
Skills For Associate Patient Access Representative Resume
- Working knowledge of computer applications and data entry skills required
- Typing and basic computer skills to include: Internet Explorer, Microsoft Outlook and Microsoft Office programs
- Three (3) years of clerical experience including at least two (2) years of admitting/patient intake experience in a hospital or ambulatory setting is required
- Three (3) years of clerical experience including at least two (2) years of admitting/patient intake experience in a hospital or ambulatory setting
- Superior interpersonal skills are important in maintaining a sound public image in dealing with patients, families, and referring physicians
- Multi-task. Proficient typing/keyboarding skills
2
Skills For Patient Access Representative Days Resume
- Insurance experience in billing, verification and/or eligibility determination. Experience in providing values based customer service
- Advanced problem solving skills and the ability
- Advanced problem solving skills and the ability to work collaboratively with other departments to resolve issues with innovative solutions ABOUT THE DEPARTMENT
- Experience with prior authorizations and billing and reimbursement
- Be diplomatic and effectively communicate during stressful situations
- Advanced problem solving skills and the ability to
- Relevant working experience to include one year of health care experience with medical insurance
- Relevant working experience; Health care experience with medical insurance knowledge and
3
Skills For Patient Access Representative 7pm to 7am Resume
- Relevant working experience; Health care experience
- Efficiently and effectively communicates with physicians, patients, their families and employees of the organization both in person and by telephone
- Effectively present information and respond to questions from groups of managers, patients, physicians, and outside Prismal personnel
- Computer skills to perform the job functions in a satisfactory accurate and productive manner
- Position requires exquisite communication skills
- Medical Office experience strongly desired
- Great interpersonal and communication skills to successfully interact with patients, pharma, physicians and payers to complete the verification process
4
Skills For Patient Access Representative With Benefits 12pm to 5pm Resume
- Testing in typing prior to interview required
- One year of experience in a healthcare setting using computerized scheduling software
- One-year experience in Hospital Business Office, Hospital Admitting, or medical office setting in related position
- Experience working in a role within a customer-facing, fast paced environment with high volume of either calls or in-person requests
- Experience using scheduling information systems
- Experience with billing and charting software programs
- Prioritize work in an environment of constant change while meeting the needs of the facility
- Prioritize work in an environment of constant change while meeting
5
Skills For Patient Access Representative M-F 11am to 8pm Resume
- Two years or more previous experience in registration in healthcare, business office and or physician billing, with reimbursement and collections
- Can establish and maintain effective working relationships with patients, employees and the public
- Demonstrates ability and willingness to adapt to special circumstances such as patient emergencies, disasters and/or staffing issues
- Demonstrates appropriate communication of information to all ages and responds to all customers/patients requests/needs, i.e., hard of hearing, etc
- Experience in healthcare setting and/or Customer Service area
- As part of the Access Center team, actively participates in ensuring that telephone calls/requests are handled in an effective and “consumer- friendly” manner
- Related work experience required in hospital financial setting
- Ensures accounts requiring authorizations and re-authorizations are identified, secured, and updated in RX Home prior to each shipment
- Demonstrated ability to handle challenging customers in a professional manner, ability to adapt in a dynamic work
6
Skills For Patient Access Representative With Benefits Days & Evenings Resume
- Experience in providing values-based customer service
- Medical insurance billing experience
- Demonstrates proficiency in medical terminology including diagnoses and diagnostic procedures
- Can operate various office equipment including, but not limited to, a computer, phone system, adding machine, copy machine and FAX machine
- Patient access, registration, or relevant work experience
- HS or Equivalent and 6 months computer experience required
- Demonstrated ability to work in a diverse group and teams
- Mentorship and/or trainer experience
7
Skills For Patient Access Representative Overnight Resume
- Organize and prioritize multiple projects, activities and deadlines
- One year of ambulatory clinic experience or in a related field
- One year of customer service experience or in a related field
- Experience with Microsoft Office, Outlook, Excel, Word, Power Point, Windows XP, Windows 7, utilization of website search engines
- Experience in medical facility, health insurance, or related area
8
Skills For Patient Access Representative 8am to 8pm Thurs Fri Sat Resume
- Two (2) years work experience in customer service, healthcare or business related field
- Experience with Microsoft Office, Outlook, Excel, Word, Power Point, Windows XP, Windows 7,
- 6 months emergency services experience related to patient registration, insurance verification, and/or medical terminology required
- Work related experience
- 1) Applies customer service and health care coverage experience to assist a broad range of clients, patients and families as it relates to admitting activities
9
Skills For Patient Access Representative IV Resume
- HS diploma or equivalent education/experience
- Experience in hospital patient access/registration or medical office with emphasis on medical insurance and collections/accounts receivable - Required
- One year of customer service work experience is required
- Working knowledge of Revenue Cycle process related to Patient Access, billing, pre-registration and scheduling
- Updating patient accounts with registration, insurance, demographic, scheduling, and billing data
- Working knowledge of ICD-10 coding, insurance verification, benefit interpretation, and point of service collections
- Greeting patients and families visiting the department
10
Skills For Patient Access Representative PRN Resume
- Triaging calls and directing them to the appropriate parties
- Caring; passion for the patients they are servicing
- Answering patient calls and scheduling appointments
- Working Knowledge of EPIC, Passport, and Microsoft Outlook applications
- Maintaining EMRs and patient records
- Obtaining and accurately entering demographic, clinical, financial information into the computer system
- Explaining and obtaining signatures on admission, clinical and financial forms
- Determining estimated cost for services being rendered
- Identifying and collecting patient financial obligation amounts, i.e. co-payments, co-insurance, deductibles, etc
List of Typical Responsibilities For a Patient Access Representative Resume
1
Responsibilities For Associate Patient Access Representative Resume
- One year of hospital clerical or medical office billing experience or equivalent combination of education and experience
- Skilled in interpreting and analyzing data
- Assess gaps in patient coverage to determine patient financial exposure prior to rendering service
- Operate multiple computer applications to register patients, schedule appointments, and retrieve surgical, testing, insurance, and financial information
- Establishes and maintains positive relationships with referral sources and staff members to promote effective partnerships of care
2
Responsibilities For Patient Access Representative Days Resume
- 6 months emergency services experience related to patient registration, insurance verification, and/or medical
- Experience with Microsoft Office applications
- Identifying all insurance payer sources
- Identifying payer order sequence
- Documenting all information collected timely and in accordance with department requirements
- Collecting accident information
- Position requires cross training at all Imaging front desks and in the reading room assisting Radiologist
- Ensures that financial protocols and requirements are met while providing caring access to service at Mercy and Providence Hospitals
3
Responsibilities For Patient Access Representative 7pm to 7am Resume
- Accepts and records calls regarding scheduling admissions
- Assign appropriate ICD-10 for registration and billing compliance purposes at the point of scheduling and registration
- Provides patients with efficient and pleasant encounter when checking in and/or scheduling appointments for services
- Maintains knowledge of PAS, hospital policies and procedures ensuring maximum utilization of facilities and staffing
- Knowledgeable in all phases of Medi-Cal program, including application process, eligibility status and case problems
- Assist with lost and found items, ensuring they get to the Security Department
- Comply with Network and departmental policies regarding attendance and
4
Responsibilities For Patient Access Representative With Benefits 12pm to 5pm Resume
- Performs quality audits and negotiate pricing
- This positon is specific to offsite location including Physical, Occupational and Speech Therapy at Covenant Outpatient Therapy locations
- Assist with financial counseling functions for Uninsured patients
- Support new patient intake and patient scheduling functions as needed
- Follows Standard Precautions and/or other appropriate precautions using personal protective equipment as
- Assists individuals in making appointments for various clinical services
5
Responsibilities For Patient Access Representative M-F 11am to 8pm Resume
- Uses procedures, policy manuals, knowledge-base and other reference materials to assist in answering various general inquiries and issues
- 6) Performs Lab Intake which includes Laboratory blood draw check in and accessioning
- 8) Performs Radiology intake which includes accessing RIS database to verify and/or release orders, schedule, and track appointments
- 9) Performs the complete registration and admitting process from start to finish
- Basic understanding of patient access services and the overall effect on the revenue cycle
- Utilizes variable software and online verification systems for screening and authorization/referral purposes. (15%)
- Transcribes orders subject to the approval of a licensed nurse requesting clarification when necessary. (10%)
- Communicates with patients, families, physicians and other healthcare team members regarding patient care and other issues. (10%)
6
Responsibilities For Patient Access Representative With Benefits Days & Evenings Resume
- Reports on time for duty, and maintains acceptable attendance according to policy
- Maintain accurate registration / collection of patient demographic information, keeping up with work flow despite interruptions
- Respects confidentiality and uses discretion when discussing patient matters
- Check for completion of charts and retrieve missing test results
- Acknowledge all calls timely and complete paging functions if required, in a clear, distinct and audible voice
- Appropriately interprets physician orders, medical terminology and insurance cards while maintaining superior service excellence
- Completes all required annual hospital and quarterly departmental training requirements in a timely manner
7
Responsibilities For Patient Access Representative Overnight Resume
- Responsible for handling daily correspondence within 12 hours
- Maintains an understanding of payer rules and requirements for insurance authorizations
- Maintains an understanding of EPIC within the scope of the job performed
- Facilitates the patient admission process including collection of patient information and financial data
- 1 Interviews the patient / family for admission and outpatient registration by entering the appropriate required
8
Responsibilities For Patient Access Representative 8am to 8pm Thurs Fri Sat Resume
- Reside in or be willing to relocate to the St. Helena, CA area
- Maintain a cooperative working relationship with staff and clinical departments, and work in a team environment
- Work independently or in conjunction with nursing or other personnel to serve the needs of the patient, their families, and/or their representatives
- Work on as-needed basis including days, evenings, nights, weekends, and/or holidays
- Provides patient education regarding third party coverage and liabilities
- Be willing to cross-train in other areas as needed / requested
- Calculates patients liability, provides estimates, collect patient portion and perform cashiering
- Verify insurance eligibility and covered benefits by using all electronic systems available to them or by phone
9
Responsibilities For Patient Access Representative IV Resume
- Escalates potential patient and/or scheduling issues as needed
- Verify patient insurance by confirming and document insurance eligibility of patient coverage
- Verify patient insurance by confirming and document insurance eligibility of patient
- Collect co-payments and outstanding balances at the time of service
- Registers patients in a courteous and efficient manner. Obtains accurate and complete registration information to ensure prompt billing and reimbursement
10
Responsibilities For Patient Access Representative PRN Resume
- Can provide in depth understanding and guidance to coworkers and contribute to improve department service levels as identified
- Follow specialty scheduling guidelines and workflows
- Knowledge of proper procedures for handling exposure tocommunicable diseases and blood borne pathogens
- Obtains and processes signed physician orders
- Inform patients of hospital rates, rules and regulations and answers patients’ questions. If unable to answer questions, investigates all avenues available to resolve concerns
- Maintains an open line of communication with all team members
- A PRN position is 1-2 shifts per week
- Office equipment, such as QUBE/Medicare Eligibility system, Blue Cross standard system, various Medi-Cal Eligibility systems, calculators, copiers, facsimile machines, telephones, typewriters, files/file cabinets, etc
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