Patient Access Representative Lead

9 hours ago

Flagstaff, Arizona, United States Northern Arizona Healthcare Corporation Full time
Job Summary

We are seeking a highly skilled and experienced Patient Access Representative Lead to join our team at Northern Arizona Healthcare Corporation. The successful candidate will provide support and assistance for internal department training of new staff for all registration, scheduling, and patient financial activities.

Key Responsibilities
  • Provide advanced degree of proficiency in computer skills and Microsoft applications, including navigation of web-based or system applications required for Patient Access Services.
  • Utilize person search methodology and correct process for system data entry of required clinical, demographic, and insurance information to the electronic medical record.
  • Provide detailed explanation of scheduled procedures or patient instructions associated to medical procedures.
  • Comply with system documentation requirements specific to the patient visit to ensure data entry reflects activities related to patient or provider contact, order documentation, insurance, and financial education/payment.
  • Provide explanation of legal forms, securing valid signature of patient/authorized party as required for services.
  • Demonstrate ability to explain compliance standards required within a healthcare environment including EMTALA and HIPAA-Privacy Patient Confidentiality regulations.
  • Identify and select appropriate insurance carrier in the patient medical record for specified dates of medical services.
  • Initiate and document insurance eligibility, benefit details, authorization requirements using web-based or system applications.
  • Perform required notifications to ensure insurance authorization for identified medical services including surgical/special interventional procedures and inpatient/observation stays is secured and documented.
  • Demonstrate advanced knowledge of CPT, ICD10 coding, and physician order documentation as required for medical services including determinations for medical necessity.
  • Provide expert knowledge of regulatory or Third Party Payer insurance requirements including Medicare, AHCCCS/Medicaid, Workers Comp and other commercial payers.
  • Educate the patient on insurance eligibility, coverage, procedure costs, alternate resources for financial assistance, and payment arrangement guidelines.
  • Ability to identify and collect patient financial liabilities and performs secured payment entry and deposit/cash reconciliation steps.
  • Navigate web-based products to initiate, document, and provide charge estimation for inpatient/observation stays, surgical/special interventional procedures or service categories based on patient requests or financial counseling needs.
  • Resolve issues related to scheduling, registration or the financial assistance application approval process.
  • On behalf of the patient, contact providers, insurance representatives, or outside agencies such as Arizona Department of Economic Security to initiate and monitor success of AHCCCS application process.
  • Monitor system work lists to provide necessary financial counseling follow up for private pay patients in the Emergency Department and inpatient/observation settings; ensure patient account is updated to reflect new payer source(s).
Requirements
  • High School Diploma or GED- Required
  • Medical Terminology- Preferred
  • Associate's Degree- Preferred
  • Minimum 2 years experience in Patient Services or related Revenue Cycle job roles- Required
  • Proficiency in Microsoft Applications (Excel, Word, PowerPoint)- Required
  • Minimum 3 years experience in a medical facility, health insurance, or related medical field- Preferred

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