Patient Access Specialist

About the role

This role is responsible for performing admitting duties for all patients admitted for services at the hospital. They are responsible for performing these functions while meeting the mission and goals of the organization and all regulatory compliance requirements. The Representative will work within the policies and processes as they are being performed across the entire organization.

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 these 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; conduct audits of accounts and assure that all forms are completed accurately and timely to meet audit standards; provide statistical data to Patient Access leadership
• Perform pre-registration of patient accounts prior to patient visits, including inbound and outbound calling to obtain demographic, insurance, and other patient information including patient financial liabilities; collect 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 tests by Medicare; distribute the ABN as appropriate; distribute and document 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
• Minimum Education: High School Diploma/GED Required
• CRCR Required within 9 months of hire

Pay & Schedule

• This position pays between $17.00 - $18.15 based on experience
• This position is an onsite role, and candidates must be able to work on-site at Bon Secours - Memorial Regional Medical Ctr in Mechanicsville, VA

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