Healthcare Access Coordinator
1 week ago
Schedule/Status: Varies; Full Time
Standard Hours/Week: 40
Position Summary:
This role is under the supervision of the Patient Access Manager/Supervisor. The Patient Access Representative plays a crucial role in embodying Parrish Healthcare's Culture of Choice, ensuring timely and precise procedures related to pre-registration, insurance validation, pre-authorization, and insurance communication.
Key Duties:
- Adhere to AIDET principles (Acknowledge, Introduce, Duration, Explanation, Thank You) in all patient interactions.
- Maintain a professional demeanor and deliver exceptional customer service.
- Utilize two patient identifiers (full name and date of birth) for accurate identification.
- Conduct pre-registration and insurance verification 3-5 days before the service date for both inpatient and outpatient services. For notifications received with less than 3 days' notice, complete within 24 hours.
- Meet or exceed performance benchmarks; process a minimum of 10 registrations per hour.
- Follow the scripted benefits verification and pre-authorization protocol in the Health Information System (e.g., Meditech) and document findings in the approved format.
- Accurately assign Insurance Plans (IPlans).
- Perform electronic insurance eligibility checks and record outcomes.
- Complete the Medicare Secondary Payor Questionnaire as necessary for imaging system retention.
- Calculate patient cost share and prepare to collect payments via phone or arrange payment plans, documenting collection efforts appropriately.
- Contact patients by phone to confirm or gather missing demographic details, quote/collect patient cost share, and guide them on where to check in on the appointment day.
- Receive and document payments from patients for scheduled services.
- Utilize the appropriate communication channels to coordinate with the Patient Access team and other hospital departments as needed.
- Ensure accurate documentation is entered in the patient record within the Health Information System (e.g., Meditech) and any other relevant systems.
- Engage with physicians to resolve issues related to prior authorizations or referrals.
- Review Patient Visit History to ensure compliance with payer-specific payment window regulations.
- Conduct follow-ups on insurance verification and pre-authorization for walk-in admissions/registrations and account status changes as per guidelines.
- Collaborate with hospital-based Case Managers to resolve pre-existing, non-covered, and re-certification issues promptly.
- Complete Advanced Beneficiary Notices (ABNs) for all Medicare patients.
- Consistently fulfill the mission; adhere to the Code of Conduct/Standards of Behavior/Values.
- Demonstrate knowledge of organizational policies, procedures, and systems.
- Participate in initiatives aimed at process improvement.
- Perform additional duties as assigned.
- Be knowledgeable of fire, disaster, and safety protocols relevant to the work environment.
- High School Diploma or GED is mandatory.
- 1 to less than 2 years of relevant experience is required.
- N/A
Eligible for various PMC-sponsored benefits, including:
- Benefits commence on Day 1
- Health, Dental, and Vision Insurance
- 403(b) Retirement Plan
- Tuition Reimbursement/Educational Assistance
- EAP, Flexible Spending, Accident, Critical, and Other Applicable Benefits
- Annual Accrual of 152 Personal Leave Bank (PLB) Hours
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