PATIENT ACCESS SPECIALIST

2 weeks ago

Albany NY USA, United States Albany Med Health System Full time
Department/Unit:

Registration

Work Shift:

Day (United States of America)

Salary Range: $18.00 - $23.79

The Patient Access Specialist is responsible for the capture of demographic and insurance information either by telephone or patient facing. Position is required to use eligibility application to invoke request to verify insurance eligibility, interpret response and capture appropriate health insurance information as it pertains to the service being rendered. The position requires ability to understand and apply contractual benefits to the service being rendered, with ability to have a financial discussion with patient regarding payment responsibility. Must be comfortable in the collection of financial responsibility from the patient based on eligibility response or estimate for services.

For Access Center and Birthplace:

Must be able to work in conjunction with Nursing Supervision and Patient Triage Manager for accurate bed assignment for inpatient and observation patients. In addition, responsible for decedent management, assuring accurate completion of death certificate and timely coordination of release of body to Funeral Home.

Apheresis and Infusion:

This team is responsible for securing financial payment for our patients requiring chemotherapy, Apheresis and other High Cost Drug Infusions. The critical nature of securing payment can't be understated given the cost of the specialty drugs being offered at Albany Medical Center. Understanding diagnosis, the prescribed drugs and authorization requirements is a significant aspect of this position. In addition, Allscripts Patient Management is integral to their workflow between SOARIAN Financials and APM.

Essential Duties and Responsibilities:

* Responsible for creating encounters in ADT representing service patient is receiving
* Responsible to discern demographic and insurance information to ensure and accurate registration
* Responsible to interpret information received from Insurance Payer regarding patient's eligibility and financial responsibility
* Responsible to discuss financial obligation of patient and collect via cash, credit card or check
* Responsible to explain regulatory forms and answer questions from patient; obtain signatures accordingly
* Responsible for scanning or managing online form template to maintain the Electronic Health Record
* Comprehend Federal, State, Third Party Payer regulations as it pertains to a hospital registration.
* Ability to work in multiple systems during a telephone call or patient facing interaction to complete an accurate registration and support clinical workflow.
* Responsible for review of services being rendered to ensure the appropriate setting of care has been assigned by the physician's office; if not, physician staff will be advised of the contractual or regulatory expectation warranting a change of setting of care. For example: Inpatient to Outpatient or Inpatient Only requirement
* Ability to respond to requests for estimates for service being rendered or expected to be rendered
* Contact patient if issues or data missing impeding ability to financially secure encounter.
* Responsible for securing encounters with extremely tight timeframes due to late booking of service
* Access Center/Birthplace ONLY: Responsible for the timely and accurately completed death certificate
* Access Center/Birthplace ONLY: Work in conjunction with Nursing Leadership for the appropriate bed placement for patients in the Emergency Department, Recovery Room, Cardiac Catheterization Lab, Direct Admits from Home, Transfers from other facilities
* Access Center/Birthplace ONLY: Multi-task of real time needs for bed placement and monitoring discharges and new reservation bed needs
* Apheresis and Infusion team ONLY: Responsible for securing payment for High Cost Apheresis and Infusion therapies; applying dosing, frequency of service is a critical component of financially securing service.

Qualifications:

* High School Diploma/G.E.D. - required
* Associate's Degree - preferred
* 3 - 5 years experience in a hospital or physician office
* required
* Computer skills (High proficiency)
* Insurance knowledge regarding payer contract interpretation including Authorization Requirements and Setting of Care (High proficiency)
* Proven customer service skill with ability to exceed expectations
* Ability to multi-task in stressful and high patient volume unit; must be able to manage pressure of very tight timeframes to execute task
* Ability to learn in classroom setting; utilizing resources
* Ability to remain composed under pressure
* Ability to review information and draw appropriate conclusion
* Good judgement and ability to be resourceful to problem solve; escalate issues as needed
* Team minded worth ethic
* Demonstrated ability interpret patient's insurance benefits and apply the applicable contractual obligations
* Critical thinking ability regarding issues with financially securing payment
* Ability to discuss sensitive concepts with patients regarding financial obligations
* CHAA - Certified Healthcare Access Associate upon hire or acquired within 2 years of hire

within 1-1/2 Yrs - required

Thank you for your interest in Albany Medical Center

Albany Medical is an equal opportunity employer.

This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:

Access to information is based on a need to know and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.

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