Healthcare Access Coordinator
2 weeks ago
Schedule/Status: Varies; Full Time
Standard Hours/Week: 40
Position Summary:
This role is under the supervision of the Patient Access Manager/Supervisor. The Patient Access Representative plays a crucial role in embodying Parrish Healthcare's Culture of Choice, ensuring timely and precise procedures related to pre-registration, insurance validation, pre-authorization, and insurance notifications.
Core Responsibilities:
- Adhere to AIDET principles (Acknowledge, Introduce, Duration, Explanation, Thank You) in all patient interactions.
- Maintain a professional demeanor and provide exceptional customer service at all times.
- Utilize two patient identifiers (full name and date of birth) for accurate identification.
- Conduct pre-registration and insurance verification 3-5 days prior to service dates for both inpatient and outpatient care. For notifications received with less than 3 days' notice, complete within 24 hours.
- Meet or exceed performance benchmarks, completing work within designated time frames (10 registrations per hour).
- Follow established benefits verification and pre-authorization protocols in the Health Information System (e.g., Meditech) and document findings in the approved format.
- Accurately assign Insurance Plans (IPlans).
- Perform electronic insurance eligibility checks and record outcomes.
- Complete Medicare Secondary Payor Questionnaire as needed for documentation.
- Calculate patient cost share and prepare to collect payments or arrange payment plans, documenting efforts accordingly.
- Contact patients via phone to confirm or gather missing demographic information, quote/collect patient cost share, and guide them on appointment procedures.
- Receive and document payments from patients for scheduled services.
- Utilize appropriate communication channels to coordinate with the Patient Access team and other departments as necessary.
- Ensure accurate documentation is entered in the patient record using the Health Information System (e.g., Meditech) and any other relevant systems.
- Engage with physicians to resolve prior authorization or referral issues.
- Review Patient Visit History to ensure compliance with payer-specific payment window regulations.
- Follow up on insurance verification and pre-authorization for previous walk-in admissions/registrations and account status changes as per guidelines.
- Collaborate with hospital-based Case Managers to address pre-existing, non-covered, and re-certification issues promptly.
- Complete ABNs (Advanced Beneficiary Notices) for all Medicare patients.
- Consistently uphold the mission; adhere to the Code of Conduct/Standards of Behavior/Values.
- Demonstrate understanding of organizational policies, procedures, and systems.
- Participate in initiatives aimed at process improvement.
- Perform additional duties as assigned.
- Be knowledgeable of fire, disaster, and safety protocols relevant to the work environment.
- High School Diploma or GED is mandatory.
- 1 to < 2 years of relevant experience is required.
- N/A
Eligible for a variety of PMC-sponsored benefits, including:
- Benefits commence on Day 1
- Health, Dental, and Vision Insurance
- 403(b) Retirement Plan
- Tuition Reimbursement/Educational Assistance
- EAP, Flexible Spending, Accident, Critical, and Other Applicable Benefits
- Annual Accrual of 152 Personal Leave Bank (PLB) Hours
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