Patient Access Specialist

2 weeks ago

Hartford, United States Charter Oak Health Center Inc Full time
Job DescriptionJob DescriptionDescription:

Position Summary

The primary responsibility of the Patient Access Specialist is completing an efficient and orderly pre-registration, insurance verification and authorization process for all scheduled outpatients while providing an explanation of our point-of-service collections as an element of good customer service. During the pre-registration process, the Patient Access Specialist discusses what co-pays, deductibles and coinsurance are due for the patient’s visit and informs patients of such responsibilities at the time of services, including any applicable sliding fee scale. The Specialist when appropriate may need to refer the patient to billing services in order to make payment arrangements or to the Eligibility coordinators to ensure screening for uninsured patients.


Essential Position Duties

  • Provides financial counseling for patients, notably uninsured/under-insured patients.
  • Assess patients’ potential eligibility for all insurance needs.
  • Request of pertinent documentation is analyzed for each of the various programs listed above for which the patient may be eligible.
  • Follow-up work is performed on uninsured/under-insured patients scheduled for appointments in order to resolve their financial responsibility prior to services being rendered.
  • Communicate all co-pay requirements to patients seeking services.
  • Carefully review patients’ account to determine the appropriate collection method.
  • Validate and processed insurance, or lack thereof, according to standards.
  • Insurance reports are worked as per standards.
  • Phone calls and/or communication are responded to within one business day.
  • Clearly document accounts are on-line.
  • Process Medicaid pending and/or indigent care adjustments according to departmental policy and procedure.
  • Third party liability and/or health insurance eligibility is thoroughly explored and verified
  • Follow-up is performed on all accounts referred to social services organization to assure timely resolution of applications for governmental assistance.
  • Communication is routinely performed with patient access staff, referral department, PSR staff, billing department and providers as needed regarding the financial status.

Knowledge, Skills Abilities

  • Excellent communication and phone etiquette skills both oral and written, as well as excellent customer service skills. ?
  • Ability to analyze data, perform multiple tasks and work independently.
  • Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers and supervisors.
  • Must be able to understand and comply with policies and procedures.
  • Must have critical thinking skills and attention to detail.
  • Must maintain a positive, professional demeanor through verbal and non-verbal communications.
  • Delivers information for patients and staff in a manner that is supportive, timely and understandable.
  • Resolves interpersonal conflicts using appropriate methods and organizational resources.
  • Serves, manages and supports internal and external customers.
  • Privacy is maintained at all times for patient and employee information.
  • Organizational Mission and Values of Respect, Integrity, Stewardship and Excellence are evident in behaviors.
  • Participates in performance improvement activities.
  • Initiative is demonstrated to proactively diagnose and resolve problems.
  • Feedback is solicited and accepted in a positive manner and constructive input is offered to support the work unit.
  • Bi-lingual (Spanish preferred)


Requirements:

Professional Experience/Educational Requirements

  • High school diploma or equivalent.
  • Associates Degree preferred or Two years’ experience working in outpatient healthcare setting, clinical service access, physician office or billing and collections.
  • Demonstrated competencies to perform insurance verification duties.
  • Demonstrated collections experience, experience in registration, or equivalent skills and experience performing Financial Counseling and/or Patient Access registration duties in a healthcare setting.
  • Ability to understand and solve complex problems dealing with governmental entitlement programs, commercial insurance requirements, contractual obligations, and reporting requirements.
  • Understanding of the charging structure and of the current trends in insurance billing and other third-party reimbursement issues. Medical terminology knowledge.

COVID-19 VACCINATION REQUIRMENTS:

COHC requires all new employees to be vaccinated against Covid-19 prior to starting employment with COHC unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.

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