Patient Access Spec I WMCG - Nights

Job Summary

This job is typically the first point of contact and must ensure a pleasant experience for patients and visitors. It involves interviewing patients and/or their representatives to obtain complete and accurate demographic, financial and insurance information, conducting intensive screening for pre-certification requirements and provider service eligibility, coordinating the collection of all estimated patient liabilities, verifying insurance benefits and coverage, and responding to customer requests.

Core Responsibilities And Essential Functions

• Receives requests for reservations (patient scheduling) from physicians offices and makes the necessary pre-admission arrangements.
• Interviews each patient or representatives to obtain complete and accurate demographic, financial and insurance information.
• Enters all patient information into the registration system.
• Obtains all necessary signatures and is knowledgeable regarding any special forms that may be required by the patients third party payer.
• Reads physicians orders to determine the procedures requested and to instruct patients accordingly.
• Escorts or arranges to have patient escorted to procedure areas and assigned rooms.
• Makes corrections and updates patient account information in computer.
• Obtains new medical record numbers for newborn admissions and other new patients.
• Documents thorough explanatory notes on patient accounts, concerning any non-routine circumstances, clarifying special billing processes.
• Maintains a working knowledge of available information system capabilities and performs all system applications that are required.
• Understands and applies WHS philosophy and objectives, and PAS policies and procedures, as related to assigned duties.
• Maintains confidentiality of patient information, in accordance with WHS policy and HIPPA regulations.
• Consistently demonstrates the ability to organize work, recognizes and establishes appropriate work priorities, and completes work in a productive manner, without creating backlogs.
• Maintains proficiency in data entry skills.
• Aids physicians and their office staff to expedite scheduling, pre-admission, Medicaid screening and pre-certifications on all accounts.
• Resolves errors and applicable Claim, DNB, and Patient Work Queues.

Customer Service

• Greets all guests with a positive and professional attitude.
• Receives patients valuables for safekeeping in the hospital safe.
• Answers incoming phone calls and follows through with requests made.
• Maintains courteous and cooperative working relationships with WHS management, patients, physicians, other professional contacts, and the general public.
• Demonstrates ability to tactfully handle difficult situations.
• Presents a well-groomed and professional image in coordination with dept/ hospital dress codes.

Budget/Financial

• Attempts to collect the estimated self-pay balance of all inpatient, outpatient and ER accounts, at the earliest possible collection control point.
• Maintains a list of health care financial assistance programs and the eligibility requirements for each program.
• Refers patients/guarantors to sources of outside funding assistance, as needed.
• Verifies insurance coverage and benefits.
• Exceeds monthly quota on a consistent basis.
• Formally reports results of self-pay collection activity to direct supervisor, on a daily basis or according to policy.
• Provides feedback to PAS management concerning self-pay collection and data integrity issues.
• Identifies and resolves Payor Denials as indicated.

General

• Observes work hours and provides proper notice of absences, tardies, work schedule changes.
• Attends select departmental meetings at the request of WHS Management.
• Completes monthly, quarterly, and annual mandatory training as required.
• Performs other duties as assigned.
• Complies with all Wellstar Health System policies, standards of work, and code of conduct.