Patient Access Specialist
2 weeks ago
Qualifications:
- Education: High school diploma or GED
- Experience: Minimum of 2 years required
- Additional Requirements: Familiarity with Medicare, Medicaid, and various commercial payers (HMO, PPO) is preferred. An associate or bachelor’s degree may substitute for experience. Certification as a Healthcare Access Associate (CHAA) is advantageous. Proficient typing skills at a minimum of 35 wpm and strong communication abilities are essential.
Job Description:
- Responsible for executing a comprehensive admissions process for all inpatient and outpatient services.
- Exemplary customer service skills are critical in this position.
- Ensure the collection of accurate information while maintaining confidentiality and informing patients of their rights in accordance with HIPAA regulations and organizational policies.
- Extensive experience and training in insurance processes are vital for success in this role.
- Adhere to compliance with state and federal regulatory requirements regarding access services.
- Responsibilities include verifying insurance eligibility, compliance, and managing point-of-service estimates and collections.
- Assist in coordinating, prioritizing, and completing front-end patient registration activities from pre-registration to discharge within the Patient Access Services Department.
- Ensure thorough verification of patient insurance and compliance with all requirements.
- Accurately complete patient registrations following departmental protocols, standards, and regulatory compliance.
- Engage with patients to pre-register or confirm appointments.
- Prioritize tasks to optimize reimbursement and mitigate financial risks for both patients and the hospital.
- Ensure all insurance prerequisites are fulfilled prior to or on the date of service, informing patients of their financial responsibilities and collecting due amounts. Identify patients needing early financial counseling.
- Refer uninsured patients to financial counseling as appropriate.
- Assist patients, guarantors, and families with insurance inquiries professionally, escalating unresolved concerns to the Financial Counselor.
- Maintain confidentiality of patient and employee information as per regulations and ethical standards.
- Support the mission of the Patient Access Services Department.
- Position requires a self-motivated individual with strong time management skills capable of handling high patient volumes in a fast-paced environment.
- Possess a thorough understanding of insurance, registration, scheduling, referrals, authorizations, and account follow-up.
- Maintain knowledge of various departmental system applications utilized in Patient Access.
- Familiarity with and adherence to all relevant state and federal regulations such as EMTALA, CMS, HIPAA, and JCAHO guidelines.
- Effectively communicate identified issues and concerns in a constructive and professional manner.
- Participate in generating ideas and solutions for process improvements.
- Respond promptly and appropriately to verbal and written requests.
- Accurately search the database to determine if a patient is new or established.
- Obtain required signatures for information release in a timely manner, following policy and procedures.
- Complete registration by verifying information and insurance for established patients or entering data for new patients prior to discharge.
- Reconfirm patient date of birth and legal spelling of their name.
- Secure appropriate signatures and scan all necessary documents (e.g., Admission/Registration Agreement, Notice of Privacy Practice, Important Message from Medicare).
- Scan patient identification and insurance cards.
- Make every effort to collect patient liabilities as appropriate and document responses if not collected.
- Distribute registration paperwork according to departmental procedures.
- Schedule procedures and follow-up appointments.
- Communicate hospital financial policies to all patients.
- Maintain an appropriate monthly assurance accuracy rate as determined by the department.
- Uphold established departmental standards regarding productivity, quality, and collections.
Apply Now
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