REMOTE Front End Patient Access Representative

**Please Note: At least 1 year of recent patient access experience is required to qualify for this position. Candidates without this experience will not be considered. **

Start Date: July 1st, 2024

Duration: Contract-to-hire opportunity. 1040 total hours, with an opportunity for conversion to permanent after completing 1040 hours worked from the start date if meeting attendance and performance expectations.

Location: 100% Remote

Schedule:

• Regular Hours: Monday-Friday, 40-hour work week, 8-hour days.
• Training Period: Monday-Friday, Central Time (CT) 8am-4:30pm.
• Post-Training Schedule: Dependent on assigned region/facility.

Compliance Requirements:

• Background check
• Education Verification (high school diploma/GED required)
• Drug Screening (9-panel, including THC)
• HIPAA training

Pay Rate: $16-21/hour, depending on experience.

Official Job Responsibilities and Duties

• Patient Information Management:
• Review mom and baby hospital face sheets to confirm and update medical record numbers and patient identity for EMR submission.
• Pull patient face sheets from hospital systems, compare information with face sheets, and enter data into the patient billing system (demographics, medical records numbers, insurance information).
• Insurance Verification:
• Perform insurance verification, correct discrepancies, and add referring providers using GMPS.
• Validate CPT codes from providers by emailing physicians for verification.
• Communication and Documentation:
• Compose emails to providers to confirm information on medical records and validate missing CPT codes.
• Notify patients, guarantors, family members, physicians, and/or supervisors of insurance coverage issues, documenting all information in the computer system.
• Maintain positive customer service and refer unresolved issues to the appropriate supervisor.
• Reconciliation and Compliance:
• Complete daily and weekly hospital admission reconciliations.
• Initiate medical record requests with the coding department.
• Verify required signatures on legal consents and insurance forms, and add/edit insurance information.
• Confirm insurance coverage and benefits using real-time eligibility software, mapping insurances to the correct plan codes.
• Enter/edit data in the computer and thoroughly document any incomplete admissions/registrations as prescribed.
• Review Physician's orders (Service date, CPT/DX codes) for unbilled encounters, ensuring all required information is listed.
• Demonstrate knowledge of all Federal, State, and Local laws pertaining to insurance rules and regulations.
• Comply with all safety regulations, policies, and procedures as defined by the customer.

Day-to-Day Responsibilities (Summary)

• Log into hospital systems to pull patient face sheets and compare patient information before entry into the billing system.
• Work heavily in GMPS for insurance verification, correcting discrepancies, and adding referring providers.
• Validate CPT codes from providers and verify codes by emailing physicians.
• Compose emails to providers to confirm information on medical records and validate missing CPT codes.
• Complete daily reconciliation (census for hospitals).
• Initiate medical record requests with the coding department.
• Obtain insurance plan codes from payer portals if RTE is not provided.

Job Requirements

• Experience: At least 1 year of recent patient access experience.
• Technical Skills: Tech-savvy with a strong ability to navigate computers and learn software.
• Work Environment: Quiet, dedicated, distraction-free home workspace that is HIPAA compliant.
• Insurance Knowledge: Understanding of insurance payers (HMO, PPO, verification of eligibility).
• Multi-tasking: Experience working in at least five systems on a day-to-day basis.
• Remote Work: Previous experience working remotely is highly preferred.

Required Compliance (if hired)

• Background check
• Drug screening (9-panel, including THC)
• Education Verification (high school diploma or equivalent required)
• HIPAA training