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Patient Access Representative - St. Elizabeth, Ascension (PRN)

Company: R1 RCM
Location: Appleton
Posted on: May 22, 2020

Job Description:

Shift: PRN (as needed) position to work in the ED. Must have open availability to work 1st, 2nd, and 3rd shift. Days& Hours will vary depending on coverage needs. Position is as needed with no set days or hours.

R1 is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals and physician practices. Headquartered in Chicago, R1 is publicly-traded organization with employees throughout the US and international locations.

Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our priority is to always do what is best for our clients, patient's and each other. With our proven and scalable operating model, we complement a healthcare organization's infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.

The Patient Access Representative will be responsible for mitigating the financial risks to our hospital clients. To do this this position is responsible for contacting patients directly and/or using alternative means to secure patient's information such as demographics, insurance/coverage and clinical information needed to determine patient's eligibility, coverage, and insurance limitations. Patient Access Insurance Specialist will use analytical skills to make decisions and explain coverage details so that patients completely understand what their financial responsibility will be. Associates in this role are empowered to identify additional resources and refer patients who might have difficulty meeting their financial responsibilities. Success in this role is measured with the use of weekly productivity scorecards.


  • Initiates contact with client hospital patients via telephone using appropriate scripting to ensure the required level of benefit and pre-certification/authorization details such as demographics, insurance/ coverage and clinical information are obtained.
  • Complete appropriate electronic forms with detailed benefit and pre-certification/ authorization information to ensure a clean claim.
  • Identifies inaccurate plan codes and corrects in the hospital's main frame.
  • Work directly with multiple insurance websites to obtain benefits and authorization validation.
  • Adheres to the guidelines set forth in the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI).

    Required Qualifications:

    • High School diploma or equivalent.
    • At least one (1) year of similar experience (patient-facing, patient access).
    • Excellent customer service skills exhibiting good oral and written communication skills.
    • Ability to type fast and accurately.
    • Must be able to communicate effectively and professionally to our patients and physician offices.

      Desired Qualifications:

      • Basic Word/Excel
      • Medical Terminology
      • Coding/Billing experience

        Physical Requirements:

        • See, read, and/or operate computers, telephones, office equipment, documents, labels, including manipulating paper requiring the ability to move fingers and hands.
        • Remain sitting, standing, or walking for long periods of time to perform work on a computer, telephone, or other equipment.
        • Frequent interactions with associates, patient care providers, patients, and visitors that require associate to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations.
        • Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use and typing for documenting patient care, accessing needed information banding patients, etc.
        • Need to walk and assist with transporting/ambulating patients and obtaining and distributing supplies and equipment. This includes pushing/pulling gurneys and portable equipment, including heavy items (over 50 lbs.).

          Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.

          Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visit:

          #LI-DB1 AG01



Keywords: R1 RCM, Appleton , Patient Access Representative - St. Elizabeth, Ascension (PRN), Other , Appleton, Wisconsin

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