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Patient Access Account Specialist I- Admitting

2 months ago

Albuquerque, United States Presbyterian Healthcare Services Full time
Overview

Now Hiring Patient Access Account Specialsit I- Admitting 

Only apply if you live in the Albuquerque Metro Area. 

Under the direction of the Patient Access Supervisor, the Patient Access Account Specialist I provides basic functions to financial clear patient accounts for government and commercial accounts prior to the date of service. Performs basic financial clearance functions, including insurance verification, authorization, collection and documentation of patient demographics, benefit analysis, and pre-service collections. The Patient Access Account Specialist I will ensure follow up on authorizations for scheduled and Urgent/Emergent procedures and admissions until date of service or discharge for admissions. The Patient Access Account Specialist I must possess a basic knowledge of Medicare (CMS) guidelines, as well as other Compliance Regulatory guidelines applicable to Patient Access to include HIPAA, EMTALA, and CMS guidelines of MSPQ.

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us:Full Time - Exempt: No Job is based:Presbyterian Work hours: DaysBenefits:  We offer a wide range of benefits including medical, wellness programs, vision and dental, paid time off, retirement and more.

Qualifications
  • High school diploma, continued education preferred
  • External and Internal Non-Patient Access Candidates: Pass Patient Academy with passing score of 85% or higher
  • Previous completion and passing of Patient Access Advocate II and III Advancement test.
  • A minimum of 2 years of work experiences in healthcare setting within Patient Access and/or billing plus strong customer service background.
  • Strong knowledge and understanding of insurance and financial processing of accounts.
  • Proficient in EPIC ADT system
  • Specialty Certifications: CHAA, CHAM or other industry equivalent certification preferred
  • Pass annual competency exam for all areas of responsibility.
  • Requires general knowledge of the customer encounter process which may include registration, contract requirements, and coordination of benefits.
  • Knowledge in Microsoft Office Products.

Education:

Essential:* High School Diploma or GED

Responsibilities
  • Achieve exceptional patient experience for patients and patient families by using CARES, AIDET and EPE tools.
  • Ability to manage conflict and appropriately request the help of a supervisor when needed.
  • Implement PROMISE and CARES behaviors in every encounter.
  • Educates patients for whom they speak regarding insurance benefits and liabilities.
  • Ensures accounts are financially cleared prior to date of service to alleviate patient concerns over hospital financial mattersEncounter Components:
  • Performs the patient registration process. Manage the accurate collection of patient data which includes but is not limited to;
  • Obtain/confirm and enter demographic and other financial and clinical information necessary for final clearance of scheduled accounts.
  • Review Urgent/Emergent admission accounts for notification, financial clearance and authorization pre-discharge.
  • Obtain missing insurance information, to include policy number, group number, date of birth, and insurance phone number if not already identified in account.
  • Verify insurance for eligibility and benefits using online electronic verification system or by contacting payer directly.
  • Review and process work queues related to Patient Access pre-visit or urgent/emergent admissions, per department guidelines.
  • Review of accounts falling within the work queues to ensure the insurance information contains accurate policy ID#s, Group Name and Numbers, Subscriber information, Authorization numbers, as well as correct payer and Coordination of benefits prior to date of service.
  • Maintain ongoing knowledge of authorization requirements and payer guidelines.
  • Maintain a proficient knowledge of Medicare (CMS) guidelines as it relates to admissions and outpatient services. Ensuring compliance with admissions forms, benefit entitlement verification, and billing requirements
  • Ensure accurate completion of MSPQ prior to date of service.
Benefits

We offer more than the standard benefits

For our employees, we offer a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more.

Why work at Presbyterian?

As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services:

Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

Inclusion and Diversity

Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Maximum Offer for this position is up to USD $21.48/Hr. Compensation Disclaimer The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.