Patient Access Data Integrity Specialist III

2 weeks ago

Jackson, Mississippi, United States Healthier Mississippi People Full time
Job Description:

To perform timely and accurate patient throughput functions such as financial screening, including utilizing systems and other means to verify eligibility, benefits, and medical necessity, obtaining prior authorization, calculating and collecting co-pays and other out-of-pocket amounts due from patients, register and schedule patients, checking patients in and out, and generally ensuring data requirements for patient demographics, insurance coverage, and financial clearance are met with a high degree of reliability and the Master Patient Index is properly maintained at all times.

Responsibilities:
  • Duties may include but are not limited to core revenue cycle patient throughput functions such as data entry, registration, scheduling, prior authorization, benefits screening, real-time eligibility verification, collections from patients for out-of-pocket amounts, and medical necessity checks.
  • Maintains strict confidentiality and adheres to all HIPAA guidelines and regulations.
  • Focusing daily on complying with policies, processes, and department guidelines for assigned revenue cycle duties.
  • Responsible for assigning accurate medical record numbers, completing medical necessity/compliance checks, providing proper patient instructions, collecting and properly entering insurance information, collecting payments from patients, and maintaining the integrity of the patient demographics in the system.
  • Has a basic understanding of payer guidelines, legal, and compliance requirements related to patient access; is knowledgeable and proficient with payer websites and other useful resources pertaining to revenue cycle functions.
  • Works assigned reports, work-lists, and patient accounts.
  • Collaborates with management and co-workers in an open and positive manner.
  • Contributes to a positive working environment.
  • Performs any other assigned duties since the duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive.
Environmental and Physical Demands:

Requires occasional exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, occasional handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional traveling to offsite locations, no activities subject to significant volume changes of a seasonal/clinical nature, occasional work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, occasional lifting/carrying up to 50 pounds, occasional lifting/carrying up to 75 pounds, occasional lifting/carrying up to 100 pounds, no lifting/carrying 100 pounds or more, no climbing, no crawling, occasional crouching/stooping, occasional driving, occasional kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent standing, occasional twisting, and frequent walking.

Requirements:

High school diploma or GED required. Seven (7) or more years of relevant experience in Admissions, Patient Registration, Scheduling, Insurance Verification, Pre-Registration, Collections, Prior Authorizations, Payor Authorizations, and/or Call Center, with a proven track record of accomplishing high-quality work in a professional manner, or Four (4) years relevant experience in Admissions, Patient Registration, Scheduling, Insurance Verification, Pre-Registration, Collections, Prior Authorizations, Payor Authorizations, and/or Call Center and hold certification as a Certified Healthcare Access Associate (CHAA) through National Association of Healthcare Access Management (NAHAM).

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