PATIENT ACCESS SPECIALIST I

Min

Max

Overview

Assists in providing access to services provided at the hospital and/or other service area. Processes registration information for the patient visit, obtaining patient demographic and third party information with a high degree of accuracy, and performs financial collections.  Performs the timely completion, preparation, and deployment of legal, ethical and compliance related documents that must be presented and thoroughly explained to the patient at the time of registration. Maintains knowledge of JCAHO, Patient Rights and Responsibilities, HIPAA, HMOs, Commercial Payers, and departmental / system policies and procedures. Work may be performed in a patient care area. Serves as a liaison between ancillary departments and other Patient Access Services areas.      

Qualifications

Education:

High School diploma or equivalent required. 

Experience:

One (1) years of business office experience, preferably in the areas of Patient Access, billing, collections, insurance principles/practices, or accounts receivable. Completion of 12 (twelve) hours of coursework in a business or healthcare related field of study may be considered in lieu of business office experience. Previous experience in Patient Access is highly desirable.  

Other Knowledge/Skills/Abilities:

Knowledge of all tasks performed in the various Patient Access Service areas is necessary to provide optimum internal and external customer satisfaction and provide the opportunity for accurate reimbursement. Demonstrates superior patient relations and interpersonal skills; demonstrates an appropriate level of mental and emotional tolerance and even temperament when dealing with staff, patients and general public, using tact, sensitivity and sound judgment; promotes a positive work environment and contributes to the overall team efforts of the department and organization.Working knowledge of computers is required, with the ability to enter and retrieve data, and electronically notate registration software, and other required applications/systems.Must demonstrate detail orientation, critical thinking, and problem solving ability.Must demonstrate excellent oral and written communication and customer service skills, with ability to maintain a calm and professional demeanor in high stress situations.Demonstrated ability to remain flexible, and consistently exercise sound judgment and initiative in very stressful situations.Ability to effectively manage competing priorities and work independently in a rapidly changing environment.Must demonstrate ability to educate, persuade, and negotiate effectively with patients and families.Knowledge of medical terminology, medical procedural (CPT) and diagnosis (ICD-9 CM) coding, and hospital billing claims preferred, but not required.

Responsibilities

• Plays a vital role in representing JMH in a positive, compassionate manner with professional communication, mannerism, and appearance
• Assist patients/visitors throughout the enterprise, providing telephone support, one-on-one assistance and way finding.
• Maintains cooperative and productive working relationships with all co-workers, physicians, management, and external customers to coordinate for optimum patient flow and throughput.

• Actively supports patient/family centered care by actions and attitude that demonstrates service excellence.

• Identifies customer service concerns and resolves and/or initiates service recovery.

• Accountable for Admissions and/or Registrations (Outpatient/ED/Pre), to ensure accurate demographic/financial data is properly obtained, entered, and documented into required system(s), which includes Bedside registrations, Pre-Registration, Point of Service Registrations, Bed Assignments and Facility to Facility Transfers, Initiates the Patient Revenue Cycle by proper identification, verification and entry of insurance and authorization information.

• Notifies and explains financial obligation to the patient/guarantor in a compassionate manner.

• Provides resources for financial assistance.

• Stays abreast of insurance and billing codes updates.

• Verifies Medicare Medical Necessity and issues ABNs for none covered services.

• Issues and explains insurance waivers, as necessary.

• Ensures outpatient physician orders are scanned and attached to the patient visit and tests are ordered via the order entry system accurately.

• Performs other related work as required or requested.