Patient Access Coordinator - Liberty - Part Time - Evenings

Responsibilities

• Analyze patient accounts; evaluate financial data for establishment of current accounts and documents comments to reflect actions taken regarding accounts to maximize reimbursement.
• Maintain knowledge of current HMO/PPO/Medicaid/Medicare/commercial insurance regulations and requirements.
• Determines all insurance coverage’s as primary, secondary, tertiary, etc.
• Completes required MSPQ questionnaires for all appropriate patients.
• Obtains and documents clinical referrals from other providers.
• Collaborates with Financial Counselors to assist patients needing financial assistance.
• Collects and deposits according to specified protocols, all required and mandatory insurance co-payments.
• Initiates on-line verification of third party Insurance Carriers and Plan Administrators to verify patient benefits.
• Evaluates and prepares chart documentation to establish that Medical Necessity guidelines have been met.
• Prepares and completes documentation that establishes Medicare Compliance such as Medicare Secondary Payor Questionnaire and Advance Beneficiary Notice.
• Documents appropriate data in account doc and guarantor notes.
• Processes Emergency and Obstetrics by notifying appropriate staff.
• Answers and directs incoming calls from Physician’s office staff, ancillary departments and other facilities.
• Answers inquiries concerning hospital policies.
• Obtains signatures for the visit for all revenue cycle documentation.
• Prepares charts, collected forms and photocopies (insurance cards) and documentation.
• Distributes, witnesses by signature and collects patient advanced directive forms/information; referring patients to appropriate personnel to address specific questions as indicated.
• Provides patients with information about their rights and responsibilities and all other duties as assigned.
• Interviews patients and obtains, verifies and enters into database complete and accurate demographic and financial information.
• Affirms and updates information as it relates to each encounter.
• Determines financial plan and coverage priority.

Qualifications

• High School Diploma, Associates Degree preferred or equivalent combination education and experience.
• One to three years experience in Registration, Billing, Customer Service, or Managed Care Organization work environment.
• Must have/gain knowledge of the Hospital Medical Staff rules and infection control policies to be effective in this position.
• Required skills and knowledge include analytical skills, computer literacy, ability to use Internet Access and utilize third party payor systems for eligibility and verification, knowledge of health insurance coverage, requirements, excellent communication, problem solving skills, ability to deal with customers who are often adversarial, ability to be flexible, organized and function well in stressful situations, ability to interact independently to resolve Customer Service issues, and understanding of medical terminology and acuity levels.
• Annual Registration Competency Review with 95% or greater score obtained.
• Yearly STAT testing completed.