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Patient Access Rep
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Part-time
- Using the Pathways Healthcare Scheduling (PHS) or Cerner databases to locate/retrieve scheduled patients for admission/registration input into STAR. Generating PHS and SurgiNet reports to facilitate pre-registration.
- Validating medical necessity via the MCA Compliance Checker where applicable.
- Requesting payment either during the pre-registration process or when the patient presents for service in accordance with MHSB/BGH policies and procedures.
- Coordinates the insurance eligibility and pre-certification/documentation (PA) processes for patients by: Verifying insurance coverage and network status by using online eligibility systems and websites to determine the patient's benefits under the insurance plan.
- Obtaining pre-certification information from the insurance company's pre-certification unit (i.e., whether pre-certification is required, if the ordering physician has completed it, etc
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