Patient Access Specialist

3 days ago

Chelsea, Michigan, United States Trinity Health Full time
Job Summary

We are seeking a highly skilled and detail-oriented Patient Access Specialist to join our team at Trinity Health. As a key member of our healthcare team, you will be responsible for ensuring the accurate and timely collection of patient demographic and financial information.

Key Responsibilities
  • Obtain and verify patient identification, demographic information, and insurance coverage
  • Determine visit-specific co-payments and collect out-of-pocket liabilities
  • Assist patients with questions regarding financial liability or refer to appropriate resources
  • Inform patients on cost of treatment, insurance benefits, and resources for payment and financial assistance
  • Secure and document payment arrangements
  • Audit authorizations for accuracy and determine if delay/deny policy needs to be invoked
  • Utilize key reports and tools to facilitate obtaining accurate insurance information
  • Communicate frequently with patients/family members/guarantors, and physicians or their office staff
  • Interview patients to collect data, initiate electronic medical records, and validate and enter data related to procedures, tests, and diagnoses
  • Determine need for appropriate service authorizations (pre-certifications, third-party authorizations, referrals) and contact physicians and Case Management/Utilization Review personnel, as needed
  • Obtain and verify the accuracy and completeness of physician orders for tests and procedures
  • Accurately use the patient search feature to find the correct patient information and disseminate data to clinical systems for patient care
  • Identify required forms or templates based on the types of services patients will receive
  • At point of service, perform insurance eligibility and determine benefit verification, utilizing EDI transactions and payer web access, and call payers directly
  • Document information within the patient accounting system through insurance eligibility/benefit verification
  • Refer accounts identified as self-pay to benefit advocacy resources
  • Conduct data search of previous accounts or payment source history, when appropriate
  • Provide financial information and patient payment options
  • Inform patient/guarantor of liabilities and collect appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits, and outstanding balances at the point of pre-registration or point of service
  • Document payments/actions in the patient accounting system and provide the patient with a patient estimate of out-of-pocket costs and a payment receipt in the collection of funds
  • Acquire and explain necessary documents, including patient identification, insurance cards, consent for treatment, assignment of benefits, release of information, waivers, ABNs, advance directives, etc.
  • Identify need for patient/guarantor signature based on patient encounter/visit
  • Scan appropriate documents
Requirements
  • High school diploma or an equivalent combination of education and experience
  • Minimum of one year experience in a customer service role with financial responsibilities
  • Experience in healthcare, insurance, or managed care industries is highly preferred
  • Experience performing medical claims processing, financial counseling, and clearance, or accounting is also highly preferred
  • Completion of certification and skills competencies, such as the Certified Revenue Cycle Specialist Professional (CRCSP) through the American Association of Healthcare Administrative Management (AAHAM) and/or Certified Healthcare Access Associate (CHAA) through the National Association of Healthcare Access Management (NAHAM), is preferred
Preferred Skills and Abilities
  • Experience with the core offerings of the Microsoft suite (Word, PowerPoint, Excel)
  • Strong communication skills, both verbal and written
  • Strong critical thinking, interpersonal, and problem-solving skills
  • Strong data entry and organizational skills
  • Able to work independently and have good time management skills
  • High level of initiative
  • Able to work concurrently on a variety of tasks/projects in a fast-paced environment
  • Able to comprehend and retain information and apply to work procedures to achieve appropriate service delivery
  • Knowledge of insurance and governmental programs, regulations, and billing processes (Medicare, Medicaid, Social Security Disability, Champus, and Supplemental Security Income Disability), managed care contracts, and coordination of benefits is highly desired
  • Working knowledge of medical terminology, anatomy, and physiology, and medical record coding (ICD-10, CPT, HCPCS) is preferred

Trinity Health is an equal opportunity employer and welcomes diversity in the workplace. We are committed to providing a work environment that is inclusive and respectful of all employees. If you are a motivated and detail-oriented individual who is passionate about delivering exceptional patient care, we encourage you to apply for this exciting opportunity.

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