Detail-oriented Patient Access Representative with extensive medical services background and strong work ethic within the Emergency Department and Outpatient Services. Managed patient-related accounts receivables at large medical facility, knowledge in medical terminology and scheduling.
•Registration of patients in the imaging department
• Analyze insurance coverage and benefits for service to ensure timely reimbursement, obtaining all PAC and/or authorizations as appropriate.
• Facilitate payment sources for uninsured patients.
•Admit/register/pre-register patients, correcting as necessary all patient demographic and financial data.
•Determine if patient’s condition is the result of an accident, performing complete research with law enforcement, employers, etc. to determine the appropriate source of liability/payment.
•Resolve insurance claim rejections/denials and remedy expediently.
•Maintain general knowledge of CMS guidelines and third party payers, specifically, Medicare, Medicaid, Commercial insurances, HMO’s, PPO’s, POS, indemnity plans, and Worker’s Compensation, etc.
•Evaluate diagnoses to ensure compliance with the Local Coverage Determination (LCD).
•Promote and maintain excellence in customer service.