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Patient Services Specialist
2 months ago
Overview:
The role of a Patient Access Representative is crucial in ensuring a seamless entry point for patients into the healthcare system. This position is tasked with initiating encounters for patients who qualify for hospital services. The Patient Access team is dedicated to maintaining the accuracy of all data entry, which includes vital demographic and financial details for each patient account. Adhering to various procedural requirements, the team handles essential data elements, insurance verification, service authorizations, and collection of patient responsibilities, including any outstanding balances. The Patient Access department plays a significant role in securing the financial viability of all patient services while ensuring compliance with federal regulations, JCAHO standards, and Department of Health protocols. Effective communication with patients, families, healthcare providers, insurance entities, and third-party payers is a fundamental aspect of this position. A professional demeanor, strong communication abilities, and excellent organizational skills are essential. Dependability, adaptability, and teamwork are also key attributes for success in this role.
Key Responsibilities:
- Meet the expectations outlined in the OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
- Accurately enter all necessary data for scheduling and registration, including patient demographics, financial details, guarantor information, and pertinent notes related to the encounter.
- Verify insurance eligibility and secure required authorizations for services provided.
- Calculate and collect the estimated patient responsibility based on benefits and contractual agreements, as well as any prior balances.
- Conduct financial assessments to determine eligibility for appropriate assistance programs.
- Clearly communicate the purpose of documents and obtain necessary signatures from patients or legal guardians.
- Represent the Patient Access department with professionalism and courtesy at all times.
- Assist the hospital during internal or external emergencies as required.
- Adapt to the dynamic needs of the department to manage patient volume across all hospital areas, which may involve reassignment and shift changes.
- Support the department in achieving established performance goals.
- Complete mandatory training and additional training as needed.
- Adhere to established standard processes to maintain team discipline.
- Collaborate with High Performance Work Teams (HPWT) to ensure a clean, efficient, and organized workplace following 5S principles.
- Coordinate and assist in monitoring workflow and tasks necessary to manage varying patient volumes.
- Provide constructive feedback to the team to identify educational and mediation needs by reporting issues, problems, and opportunities.
- Demonstrate competence in performing assigned duties in a manner that meets the specific needs of the patient population served.
- Adapt assessment and service methods to accommodate the unique physical, psychosocial, cultural, and developmental needs of each patient.
- Take personal responsibility for compliance with all relevant policies, procedures, and standards set by regulatory agencies and the hospital.
- Perform all duties while safeguarding patient confidentiality and refraining from disclosing any confidential information unless necessary for job functions.
- Carry out additional responsibilities as assigned.
Qualifications:
- High School Diploma or equivalent experience required.
- 1 to 3 years of relevant experience preferred.
Work Schedule:
5 Days - 8 Hours
Work Type:
Full Time
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