Patient Access Specialist
Full Job Posting
Qualifications:
- 1 year of Patient Access operations activities (scheduling/registration/insurance) or related experience (billing, collections, accounts receivables)
- Previous experience in one of the following: scheduling, registration, insurance, billing, collections, and customer service in either a hospital or physician's office setting
- May consider successful completion of 1100+ related Career Tech program or one year of college coursework in a related field in lieu of experience
- Preferred Qualifications:
- College coursework in related field or Healthcare Certification (AAHAM CRCS, HFMA CRCR, NAHAM CHAA)
- Previous experience with medical terminology, basic ICD 10 and CPT coding
Responsibilities:
- The Patient Access Specialist responsibilities include, but are not limited to, the following:
- Ensures the appropriateness of complex patient access transactions including coverage eligibility, insurance verification, patient portion calculation and authorization requirement activity utilizing available systems and resources according to assigned protocol
- Performs financial counseling activity including screening for government programs and financial assistance, payment options and arrangements, processing point of service payments, verifying patient demographic information, obtaining signatures for required paperwork, document imaging and following documentation standards to facilitate efficient patient access according to assigned protocol
- Possesses the ability to use analytical thinking, independent judgment, and clinical knowledge to adjust service area schedules and accommodate special requests from internal and external customers
- Accepts inbound phone calls from patients, physician offices, insurance carriers, etc. with the intent to resolve the concern immediately.
- Collects patient payments and follows levels of authority to ensure financial clearance
- Documents all patient account activities concisely, including authorization and patient liability requirements
- Performs filing, data entry, and other duties as assigned.
- Responds promptly to patient inquiries regarding pre-care services, policies, coverage, benefits and financial liability * Utilizes multiple resources to resolve patient or payor inquiries while on the phone or preparing/reviewing patient accounts or prior authorization requirements
- Understands different payer regulations and can communicate effectively with patients regarding their coverage benefits and financial liability
- Participates in team-oriented process improvement initiatives for the department and organization
- Participates in continuous quality improvement efforts, establishes goals with supervisors and tracks progress
- Interprets and maintains compliance with performance standards, federal and state regulations including EMTALA and HIPAA, policies, procedures, guidelines, and third-party contracts
- INTEGRIS Health is an Equal Opportunity/Affirmative Action Employer. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.
Preferred Qualifications
- College coursework in related field or Healthcare Certification (AAHAM CRCS, HFMA CRCR, NAHAM CHAA)
- Previous experience with medical terminology, basic ICD 10 and CPT coding
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