Healthcare Access Coordinator
5 days ago
Job Summary:
We are seeking a skilled and detail-oriented Healthcare Access Coordinator to join our team at Parrish Medical Center. This role is ideal for an individual who enjoys working in a fast-paced environment and is committed to delivering exceptional patient care.
About the Role:
The Healthcare Access Coordinator will be responsible for promoting timely and accurate processes associated with pre-registration, insurance verification, pre-certification, and insurance notification. This includes performing pre-registration and insurance verification within 3-5 days prior to date of service for both inpatient and outpatient services.
Main Responsibilities:
- Customer Service: Always maintain professional image and demonstrate excellent customer service while interacting with patients.
- Patient Identification: Always use two patient identifiers (patient full name and date of birth) for accurate patient identification.
- Pre-Registration and Insurance Verification: Perform pre-registration and insurance verification within 3-5 days prior to date of service for both inpatient and outpatient services.
- Meet Performance Expectations: Meet/exceed performance expectations; complete work within the required time frame (10 registrations per hour).
- Benefits Verification and Pre-Certification: Follow scripted benefits verification and pre-certification format in Health Information System (i.e. Meditech) custom benefits screen and record benefits and pre-certification information in the approved standard format.
- Insurance Plans Assignment: Assign Insurance Plans (IPlans) accurately.
- Electronic Insurance Eligibility Confirmation: Perform electronic insurance eligibility confirmation and document results.
- Medicare Secondary Payor Questionnaire: Complete Medicare Secondary Payor Questionnaire as applicable for retention in imaging system.
- Patient Cost Share Calculation: Calculate patient cost share and be prepared to collect via phone or make payment arrangement and document account with collection efforts accordingly.
- Patient Communication: Contact patient via phone (with as much advance notice as possible, preferably 72 hours prior to date of service) to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct patient on where to present at time of appointment.
- Payment Collection: Receive and record payments from patient for services scheduled.
- Communication and Documentation: Utilize appropriate communication system to facilitate communication with Patient Access team and other hospital departments as necessary. Ensure appropriate documentation is entered in standard format on the patient record.
- Physician Collaboration: Contact physician to resolve issues regarding prior authorization or referrals.
- Patient Visit History Research: Research Patient Visit History to ensure compliance with payor specific payment window rules.
- Follow-Up Tasks: Perform insurance verification and pre-certification follow-up for prior days walk-in admissions/registrations and account status changes by assigned facility as per guidelines.
- Caseworker Collaboration: Communicates with hospital-based Case Manager as necessary to ensure prompt resolution of pre-existing, non-covered, and re-certification issues.
- Advanced Beneficiary Notice: Complete ABNs (Advanced Beneficiary Notice) on all Medicare patients.
- Code of Conduct: Always serves to fulfill the mission; practices and adheres to the Code of Conduct/Standards of Behavior/Values.
- Knowledge and Understanding: Demonstrates knowledge and understanding of organizational policies, procedures and systems.
- Process Improvement: Participates in process improvement initiatives.
- Other Duties: Performs other duties as assigned.
- Safety Procedures: Knows fire, disaster and safety procedures and regulations as pertains to the work area.
Requirements:
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