Dedicated and reliable Lead Patient Access Representative with 20 years experience. Skilled in insurance benefit and eligibility verification, authorizations and data entry. Well versed in HIPPA and EMTALA compliance. Provides quality customer service to patients, families and colleagues alike. Strong adaptability and multitasking skills.
Overview
21
21
years of professional experience
Work History
Lead Patient Access Representative
Bakersfield Heart Hospital
Bakersfield, CA
06.2003 - Current
Perform multiple types of patient registrations, including emergent, elective and direct admissions.
Gather and input demographic and insurance information into EHR, assuring correct patient identification while maintaining 95%-100% accuracy.
Assist patients with understanding and signing registration consents and forms.
Verify insurance eligibility and benefits via provider portals or telephone.
Request and obtain authorizations for outpatient, observation and inpatient services.
Perform ABN compliance checks for elective outpatient procedures and services.
Update patient admission status in EHR per physician order and place in assigned bed via the bed board.
Work closely with revenue cycle director and business office staff to assist with account audits/corrections to ensure clean claims.
Obtain elective, inpatient and retro authorizations.
Submit requested clinical documentation to insurance companies for approval of treatment.
Administrator for provider insurance portals, assisting with staff access and proper use.
Practice HIPAA and EMTALA compliance daily with every patient, staff and third party interaction.
Operate PBX switchboard and perform overhead paging.
Collect and post payments made by patients and insurance companies. Assist patients with payment plan and automatic payment arrangements.
Perform medical insurance appeals for technical denials.
Assist patients to answer or resolve any billing and account questions/concerns.
Maintain staff schedule, PTO requests, attendance and timekeeping for the Patient Access department.
Monitor and coach the patient access team for performance and accuracy.
Maintain, update and implement policies, procedures and processes for the patient access department.
Education
High School Diploma -
Kern High School District
Bakersfield, CA
06.2000
Skills
Medical insurance knowledge
Medical treatment authorizations
Insurance denials and appeals
Payment collection and processing
Patient interviewing skills
Customer service
Microsoft Word, Excel and Outlook
Paragon EHR
HIPAA and Emtala knowledge
PBX functions
Business Office Functions
Management and leadership
Timeline
Lead Patient Access Representative
Bakersfield Heart Hospital
06.2003 - Current
High School Diploma -
Kern High School District
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