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Healthcare Access Specialist
2 months ago
Position Overview:
Under the supervision of the Manager, the Patient Access Technician plays a crucial role in ensuring the precision and completion of patient accounts in accordance with departmental guidelines, policies, and regulatory compliance. This includes handling pre-admission, admission, pre-registration, and registration tasks, while confirming that all insurance prerequisites are fulfilled prior to patient discharge and actively pursuing cash collections.
Qualifications:
Credentials:
Education:
Essential:
* High School Diploma
Additional Information:
Experience: A minimum of one year in a business environment with proficiency in computer operations and data entry is preferred, or two years of post-secondary education. Bilingual candidates are preferred. The individual should demonstrate performance standards (ownership, teamwork, communication, compassion) that enhance patient satisfaction and uphold service excellence principles.
Other responsibilities may be assigned as necessary. The candidate will possess a suitable combination of education, experience, and qualifications.
Key Responsibilities:
1. Assess insurance coverage and benefits for services to guarantee prompt reimbursement, acquiring all necessary PAC and/or authorizations as required.
2. Assist uninsured patients in identifying payment options.
3. Investigate if a patient's condition results from an accident, conducting thorough research with law enforcement, employers, etc., to ascertain the correct source of liability/payment.
4. Admit, register, or pre-register patients, making necessary corrections to all patient demographic and financial information.
5. Address and resolve insurance claim rejections/denials promptly.
6. Accurately calculate and collect cash payments from all patients, ensuring daily cash deposit reconciliation.
7. Maintain a comprehensive understanding of CMS guidelines and third-party payers, including Medicare, Medicaid, Commercial insurances, HMOs, PPOs, POS, indemnity plans, and Workers Compensation.
8. Review diagnoses to ensure adherence to Local Coverage Determination (LCD) standards.
9. Execute necessary tasks to ensure all accounts are processed with accuracy and efficiency.
10. Foster and uphold excellence in customer service.
