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Patient Access Specialist II
2 months ago
POSITION SUMMARY
The Patient Access Specialist II plays a crucial role in enhancing departmental efficiency through various responsibilities, including but not limited to scheduling, registration, patient pre-admission and admission, as well as reception and discharge operations. This position requires the collection of comprehensive and precise patient demographic information. Additionally, Patient Access Specialists must utilize compliant techniques for patient liability collection before, during, and after the date of service.
KEY RESPONSIBILITIES
Responsibilities include, but are not limited to:
- Welcoming patients in accordance with Conifer Health Solutions' Standards of Care, delivering exceptional customer service, and completing thorough patient registration at the time of service. This includes explaining and securing necessary hospital and patient legal documents (e.g., Advance Directives, Conditions of Services, Consent for Treatment, Important Message from Medicare, EMTALA, etc.). Scanning Protected Health Information and creating patient information packets for upcoming hospital services may also be required. Assistance with scheduling diagnostic procedures may be needed, including data entry in the scheduling system and providing appointment instructions.
- Informing patients about their financial responsibilities, employing compliant techniques for collecting patient liabilities before, during, and after the date of service, and performing cash reconciliation and secured payment entry in accordance with financial policies and procedures.
- Conducting medical necessity checks and verifications as per the Centers for Medicare & Medicaid Services guidelines, verifying insurance, benefits, coverage, and eligibility. Completing assigned registration financial clearance tasks, obtaining insurance authorizations for both scheduled and unscheduled hospital services, and ensuring inpatient visit notifications to payors. May also assist in scheduling and coordinating post-discharge care for patients.
To excel in this role, candidates should possess the following knowledge, skills, and abilities:
- Typing proficiency of at least 35 words per minute.
- Demonstrated proficiency with PC/CRT/printer.
- Familiarity with hospital functions and relationships is preferred.
- Strong customer service skills and experience.
- Ability to thrive in a fast-paced environment.
- Effective oral and written communication skills.
- Completion of a Medical Terminology course is required.
- Understanding of Third Party Payor requirements is preferred.
- Knowledge of compliance standards is preferred.
- Capability to perform essential duties in at least two Patient Access service areas, including the Emergency Department.
- Utilization of proper negotiation techniques to professionally collect outstanding payments from patients/guarantors.
- Ability to build and maintain collaborative relationships with both internal and external clients to enhance communication and productivity.
- Competence in interpreting physician orders, medical terminology, and insurance cards while adhering to Conifer Standards of Care.
EDUCATION AND EXPERIENCE
Preferred qualifications include:
- High School Diploma or GED.
- 0 - 1 year of experience in a customer service role.
- 0 - 1 year of administrative experience in a medical facility, health insurance, or related field is preferred.
- Some college coursework is preferred.
Physical demands necessary to perform the essential functions of this position include:
- Ability to sit at a computer terminal for extended periods.
- Occasional lifting or carrying of items weighing up to 25 lbs.
- Frequent prolonged standing, sitting, and walking.
- Occasional assistance with wheelchair transport for patients with mobility challenges.
The work environment characteristics described here are representative of those an employee may encounter while performing the essential functions of this job:
- Hospital administration settings.
- Potential exposure to life-threatening patient conditions in patient care locations.
Flexibility in working hours and days is required based on departmental demands. The role may involve resolving issues between physician offices and patients, with the potential for high patient volumes and challenging interactions.
