Pre-Access Representative - Potsdam, NY (Full Time)

Job Title: Pre-Access Representative
Department: Patient Access     
Location: 201 Market St., Potsdam, NY                    
Hours Per Week: 40 hours weekly
Schedule: Monday to Friday, 8 hour shifts, variable days between the hours of 7:30am-5pm                       
               
SUMMARY:
The Pre-Access Representative will be responsible for handling the flow of scheduling calls. The essential responsibilities include pre-registration, scheduling, obtaining accurate demographics, providing exam preparations, and collection of appropriate authorizations/ICD codes in a courteous and efficient manner. They will be responsible for completing accounts with eligible insurance and authorization and complete patient pre-registration for scheduled procedures. The Representative will verify the patient payer eligibility, benefits/coverage, and estimated payment responsibility, confirm authorization requirements and secure on the account. The Representative will complete pre-registration phone interviews, to include obtaining necessary pre-registration information, including demographics, insurance information, and Medicare MSPQ, with documentation completed in the electronic medical record account. During the pre-registration interview, the representative will notify patient of potential financial responsibility and collect payment via phone, review issued Medicare ABN (Advance Beneficiary Notification), provide direction to facility and registration desk, and educate the patient regarding what items are required as part of the patients facility registration process.

Responsibilities:

• Manages patient scheduling and registration by accurately identifying patients, obtaining demographic, medical, and financial information, and securing necessary documentation, orders, and authorizations in compliance with organizational policies.
• Coordinates appointment scheduling based on clinical guidelines and medical appropriateness while handling a high volume of calls, addressing inquiries, and resolving patient/customer concerns professionally.
• Executes revenue cycle functions, including insurance verification, precertification, real-time eligibility checks, Medicare documentation, and collection of copays, deductibles, and outstanding balances at the time of service.
• Ensures accurate data entry and compliance, selecting correct financial classes, correcting registration errors, and adhering to payer and regulatory requirements to minimize claim denials and delays.
• Delivers exceptional customer service, maintaining professionalism and confidentiality, providing timely updates on wait times, addressing complaints, and escalating issues to leadership when necessary.
• Supports operational and financial integrity, balancing cash drawers, issuing receipts, securing funds daily, and referring patients to financial assistance programs as appropriate.
• Engages in staff development and continuous improvement through training, participation in meetings, performance improvement initiatives, and orientation of new team members.

Required Qualifications:

• High School Diploma or GED required
• Associate’s degree or higher in healthcare administration, business administration, or related field desired
• At least 1-3 years of customer service, administrative, and/or data entry experience preferred
• One to two years of previous experience in hospital related field preferred
• Experience with database software applications desired
• Note: Not all per diem roles are union eligible

Preferred Qualifications:

Union:

1199-200B Clerical Workers (CPH)

Education:

Licenses / Certifications:

Physical Requirements:

S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

Pay Range:

$18.70 - $27.44

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.