Patient Access Associate Specialist

About the role

The Patient Access Associate Specialist plays a critical role in ensuring a seamless and positive patient experience by accurately managing patient registration and access processes within the healthcare revenue cycle. This role ensures data integrity, regulatory compliance, and a positive patient experience while directly influencing revenue cycle KPIs such as registration accuracy, point-of-service collections, and first-pass claim rates. Serves as the first point of contact for patients onsite in healthcare facilities and are essential in supporting clinical and financial operations for financial health through accurate data entry, auditing, and communication.

Responsibilities

• Assign accurate MRNs, complete medical necessity / compliance checks, provide proper patient instructions, collect insurance information, receive and process physician orders, and utilize an overlay tool while providing excellent customer service as measured by Press Ganey.
• Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable.
• Adhere to policies and provide excellent customer service in interactions with the appropriate level of compassion.
• Be held accountable for point of service goals as assigned.
• Utilize quality auditing and reporting systems to ensure accounts are corrected, including accounts for other employees, departments, and facilities. Conduct audits of accounts and assure that all forms are completed accurate, timely to meet audit standards and provide statistical data to Patient Access leadership.
• Manage the pre-registration of patient accounts prior to patient visits, including inbound and outbound calling to obtain demographic, insurance, and other patient information including the patient financial liabilities, collecting point of service collections as well as past due balances including payment plan options.
• Explain general consent for treatment forms to the patient/guarantor/legal guardian, obtain necessary signatures and witness's name. Explain and distribute patient education documents, such as Important Message from Medicare, Important Message from Tricare, Observation Forms, MOON form, Consent forms, and all forms implemented for future services.
• Review eligibility responses in insurance verification system and appropriately select the applicable insurance plan code, enter benefit data into system to support POS (Point of Service Collections) and billing processes to assist with a clean claim rate.
• Accurately screen medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of test by Medicare and distribution of the ABN as appropriate. Responsible for distribution and documentation of other designated forms and pamphlets.

Requirements

• 1+ years of customer service experience
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.
• High School Diploma/GED
• CRCR Required within 6 months of hire (Company Paid)

Pay & Schedule

• This position pays between $17.00 - 18.15/hr based on experience
• This position is on-site, and candidates must be able to work on-site at Ballad - Johnson County Community Hospital, Mountain City, TN

Benefits

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement
• Healthcare, time off, retirement, and well-being programs
• Quarterly and annual incentive programs for all employees who go beyond and keep raising the bar
• Professional development with a professional certification relevant to field and tuition reimbursement