Healthcare Access Specialist
2 weeks 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 protocols, policies, and regulatory compliance. This includes managing pre-admission, admission, pre-registration, and registration processes while ensuring that all insurance prerequisites are fulfilled prior to patient discharge and facilitating cash collection.
Qualifications:
Credentials:
Education:
Essential:
* High School Diploma
Additional Information:
Experience: A minimum of one year of business experience with proficiency in computer operations and data entry is preferred, or two years of higher education. Bilingual capabilities are advantageous. The candidate should demonstrate performance standards (ownership, teamwork, communication, compassion) that enhance patient satisfaction and uphold service excellence principles.
Other responsibilities may be assigned as needed. The individual will possess a suitable combination of education, experience, and qualifications.
Key Responsibilities:
1. Assess insurance coverage and benefits for services to guarantee timely reimbursement, securing all necessary PAC and/or authorizations as required.
2. Assist uninsured patients in identifying payment options.
3. Investigate if the patient's condition results from an accident, conducting thorough research with law enforcement, employers, etc., to identify the correct source of liability/payment.
4. Admit, register, and 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 compliance with Local Coverage Determination (LCD).
9. Execute necessary duties to ensure all accounts are processed with accuracy and efficiency.
10. Foster and uphold excellence in customer service.
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