Hospital insurance representative vs patient access representative

Differences between hospital insurance representative and patient access representative duties and responsibilities

Hospital insurance representative example responsibilities.

• Cold-Cal to generate leads for individual life and disability insurance and annuities.
• Verify that each CPT code are paid correctly and according to fee schedule for any overpayment or underpayment ..
• Provide financial counseling for patients and their families by explaining financial policies and providing available resources for alternative payment.
• Fill out refund form with copy of all relate EOB's when credit balances are find on account.
• Serve as a resource/ advocate to all employees regarding claims problem resolution, benefits explanations and EOB issues.
• Collect patient demographic & insurance information via telephone for outpatient surgery and radiology.

Patient access representative example responsibilities.

• Use EMR software to manage patient records and files; reinforce and uphold patient confidentiality as required by HIPPA and clinic.
• Conduct intensive screening of all Medicare, Medicaid and manage care patients for provider service eligibility.
• Educate eligible applicants about Medicaid manage care and how to access benefits in a manage care environment.
• Run internal reports to ensure ICD 9 and CPT procedure codes are accurate for billing for Medicare and Medicaid patients.
• Deliver quality customer service and compassion while obtaining demographic and financial data from patients seeking emergency medical services.
• Operate front desk check-in, preparation of charts, receive payments and balance books at the end of the day.
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