Patient Access Specialist I

2 weeks ago

Milford, United States Bayhealth Full time

**Location: Occupational Health**

**Status**:Relief As Needed Hours

**Shift**:Variable

**General Summary**:
Under the supervision of the Patient Access, Supervisor and Team Lead, the Patient Access Specialist I (PAS I) performs complete and accurate registration and admissions functions to provide information for continuity of care and revenue cycle efficiency. The PAS I is an entry level position with the responsibility to obtain and verify demographic, insurance, and eligibility information during the registration process including point of service payments. Provides payment estimates for out-of-pocket costs. In this role the PAS I is assigned to one department/location.

The PAS I must demonstrate competence in each essential duty to become eligible for the PAS II position. A minimum of one-year patient registration experience in the assigned department is required for consideration for PAS II.

**Responsibilities**:
1. Customer Service; meets the needs of the patient/ patient representative by using clear and respectful communication while obtaining necessary information.
2. Timely and precise completion of each registration, following all department processes and procedures. Must verify that all demographic and insurance information is accurate; utilizes Epic, payer websites or telephone for insurance verification. Obtain current copies of insurance cards and photo identification. Secures patient signatures for required forms.
3. Enter data related to procedures, tests, and diagnoses (when applicable). Determines the need for medical necessity and follows the advanced beneficiary notice process when appropriate based on pre-established guidelines.
4. Obtains and verify the accuracy of physician orders for tests and procedures to minimize risk to hospital reimbursement.
5. Identify the patient using two factor identification. Complies with EMTALA regulation when creating the quick registration account (when applicable).
6. Ensure authorizations (pre-certifications, prior authorization, referrals) are obtained prior to service, as applicable. Notify supervisor of any insurance authorization issues.
7. As appropriate, completes Medicare Secondary Payer questionnaire without errors to support compliance with CMS policies.
8. Perform point of service collections: Responsible for meeting monthly collection goals, having financial conversations with patients as it relates to their co-payments, deductibles, co-insurance, deposit amounts and outstanding balances. Documents payments/actions in the EHR and provides the patient with a payment estimate (when applicable). Follows cash drawer balancing procedures, as appropriate, reconciles payments against deposit totals.
9. Review and resolve account errors in assigned work queues.
10. Maintain qualitative and quantitative individual and team performance targets.
11. Responds to disaster and mass casualty situations in a calm and appropriate fashion. Maintains and understands the emergency management processes and procedures specific to that unit.
12. Adheres to department and system policies. Interact with co-workers, visitors, and other staff consistent with the Bayhealth values.
13. Scheduling (as applicable) - may need to schedule appointments, following procedures and protocols. Assist patients with referral needs in obtaining additional appointments with specialists, and insurance approval authorization for additional visits.
14. Patient flow (as applicable) - maintain efficient patient flow in the registration and check-in process. Accurately complete reception duties in accordance with policies.
15. All other duties as assigned within the scope and range of job responsibilities.

**Required Education, Credential(s) and Experience**:

- Education: High School Diploma or GED
- Credential(s): None Required
- Experience**:Required**:One (1) year in a customer service role.

**Preferred Education, Credential(s) and Experience**:

- Education: Associate Degree; Associate Degree Business Administration OR Related field
- Credential(s):

- Experience: Preferred: Experience in healthcare or medical office environment. Knowledge of medical terminology.

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