Patient Access Coordinator - Longtown, PRN Hours Variable

Skill Summary

Skills required for this role include working knowledge of registration systems, Medicare/Medicaid/Third Party Liability/Workers Compensation requirements, proficiency in Microsoft Office (Word, Excel, and Outlook), knowledge of applicable state and federal regulations, excellent negotiating and analytical skills, strong verbal and written communication skills, and excellent interpersonal skills.

Job Summary

The Patient Access Coordinator at North Mississippi Health Services supports the organization's financial health by managing insurance information, point of service collections, and financial arrangements. This role involves scheduling, pre-certifying, and pre-registering patients, communicating with patients and insurance companies, and ensuring timely and accurate patient flow and collections.

Job Functions

• Scheduling:
• Responsible for scheduling/rescheduling, pre-certifying, checking medical necessity, and pre-registering patients for appointments, diagnostic tests, and outpatient procedures as ordered by referring providers.
• Obtains necessary information required for scheduling, pre-certification, and pre-registration.
• Obtains and/or verifies patient demographics, insurance information/eligibility, and benefits.
• Notifies patients of the location of the appointment date & time, test, and/or procedure.
• Customer Experience:
• Obtains crucial confidential patient identification information including patient records, signatures, and payment information repeatedly and ensures HIPAA guidelines are enforced.
• Communicates NMHS' organizational revenue cycle and financial policies including estimates, charity plans and payment options to patients and patient representatives.
• Provides bedside registration to obtain consent form signatures, collect insurance, and other confidential information pertinent to ensure accurate medical record data entry that aligns with CMS and other regulatory agencies.
• Collections & Financial Arrangements:
• Ensures team members are providing estimates to guarantors for elective procedures and collection attempted at the point of pre-registration or point of service.
• Ensures team members are administering ABNs when necessary.
• Ensures accounts are financially secure prior to service.
• Takes proactive, corrective action through systematic and procedural development to reduce incoming denials.
• Denials Management:
• Corrects front end errors real time to minimize denial throughput.
• Develops strategy for consistently obtaining accurate, timely, and beneficial patient demographic information.
• Reviews post service denials to assist in developing front end strategies to reduce denial inflow.
• Identifies trends and reports potential significant and recurring issues along with possible solutions to leadership.
• Contract Management:
• Maintains familiarity with payer methodologies to ensure accurate estimates are communicated with patients & system variances are communicated with leadership.
• Manages expected reimbursement to ensure appropriate patient portion is collected prior to service.
• Develops strategy for partnering with business office to ensure estimates & transparency are accurate.
• Analyzes estimate variances to understand where/why deviations occurred.
• Identifies trends and reports potential significant and recurring issues along with possible solutions to leadership.
• Communication:
• Effectively communicates information to staff, internal and external customers.
• Creates strong customer service orientation and collaboration.
• Provides excellent customer service to all internal and external customers.
• Liaison:
• Contacts insurance companies, patients, and providers regarding authorizations, medical necessity, and financial responsibility.
• Serves as liaison between payers and hospital departments/physician offices or patients in resolving front end errors which would result in denials.
• Reporting:
• Aids in the preparation of monthly error reports and other error reports as requested.
• Aids in the preparation of monthly collections reports and other collection reports as requested.

Qualifications

• Education:
• You must have a High School Diploma or GED or higher.
• Licenses and Certifications:
• No specific licenses or certifications are required.
• Work Experience:
• 1-3 years of experience/knowledge of managed care reimbursement methodology including ICD-10, CPT-4 and/or HCPCS and DRGs is preferred.
• 1-3 years of Patient Access, Claims, Billing/Follow Up, or Revenue Cycle experience is preferred.
• Knowledge, Skills, Abilities:
• Working knowledge of Registration systems, Medicare/Medicaid/Third Party Liability/Workers Compensation requirements.
• Proficient in Microsoft Office (Word, Excel, and Outlook).
• Knowledge of applicable state and federal regulations relating to registering accounts and collecting at point of service.
• Excellent negotiating and analytical skills.
• Strong verbal and written communication skills.
• Excellent interpersonal skills.
• Effectively and efficiently prioritizes and organizes tasks.
• Provides supervision to direct reports.
• Develops, implements/evaluates projects (timely & efficient manner).
• Evaluates and provides coaching for all employees within the scope of responsibility.
• Ensures accurate and timely collection of all appropriate patient estimates.
• Ensures effective monetary management of Deposits.
• Ensures timely and accurate processing of accounts in accordance with best practices, defined workflow, procedures, and applicable legislature/ regulations.
• Gathers and relays information with knowledge, tact, and diplomacy.
• Experiences daily contact with co-workers, patients, payers, and other NMHS/NMMC staff members.
• Exhibits strong written and verbal communication skills.
• Reflects a positive, caring attitude toward clients, patients, staff, and the public we serve.
• Evaluates and coaches reporting employees to accomplish major goals and objectives.
• Develops, implements/evaluates projects in a timely & efficient manner.