Patient Access Specialist

About the role

This position greets and receives patients into the health care facility, responsible for accurate and timely processing of patient demographics and insurance information, communicates and supports hospital departments using scheduling system as appropriate, and obtains electronic signature for consent to treat and patient financial obligation.

Responsibilities

• Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
• Completes managed care responsibilities in regard to obtaining pre-certification and authorizations.
• Completes WVU Medicine standard consent form, notice of privacy practice and/or other necessary paperwork related to registration and presents to patient/family/legal guardian for signatures.
• Obtains electronic signature for consent to treat and patient financial obligations.
• Collects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems.
• Directs patients needing financial assistance to speak with a Financial Counselor.
• Prepares armband for patient identification.
• Balances daily receipts and cash drawer for patient payments as needed.
• Follows up on accounts as indicated by system flags (courtesy dismissal/comments/red stickers).
• Initiates auto accident liability coverage.
• Identifies all patients involved in an auto accident and obtains all pertinent information regarding medical or non-fault liability and documents in registration/billing systems.
• Initiates ESRD (end stage renal disease) screening.
• Identifies ESRD patients and obtains all pertinent information regarding coverage by SSI and documents in the registration/billing systems.
• Initiates Veterans Administration eligibility screening.
• Identifies VA eligible patients and coordinated admission/treatment with VA and documents in the registration/billing systems.
• Initiates Black Lung SSI screening.
• Identifies Black Lung patients and documents in the registration/billing systems.
• Initiates Workers Compensation screening.
• Accurately identifies all patients seeking treatment for work related injuries.
• Assists in completion of appropriate paperwork and documents in the registration/billing systems.
• Initiates MSPQ (Medicare secondary payer questionnaire).
• Obtains all information regarding MSPQ and documents in the registration/billing system.
• Answers phone calls in a professional and courteous manner.
• Uses phone system in correct manner.
• Schedules, reschedules, or cancels patients in accordance with hospital workflows.
• Checks for order completeness and validate order against scheduled service.
• Communicates with and supports hospital departments using the scheduling system.
• Follows hospital, state, and federal guidelines for ensuring safe environment for workers, patients, and the public.
• Ensures compliance by staff to hospital, governmental, and insurance regulations.
• Complies with Notices of Privacy Practices, and the Patient’s Rights and Responsibilities and cooperate with the WVUH Corporate Compliance Program during employment.
• Communicates and interacts with clients, families, visitors, physicians, departmental, and hospital staff and the public in general in a manner that demonstrates professionalism and concern for the individuals’ need(s).
• Participates in the processes to assess and improve the services provided and compliance with regulatory requirements.
• Reports results of assessments and improvement processes to the appropriate administrative levels.

Qualifications

• High School diploma or equivalent.
• Associate degree in a related medical field such as medical assisting or medical office administration preferred.
• Experience in a medical office setting preferred.

Skills and Abilities

• Accurately utilizes applicable computer software and equipment for access processing.
• Demonstrates ability to follow down time procedures.
• Knowledge of procedure to report and/or document unsafe/hazardous conditions, incidents and defective equipment in compliance with hospital policy.
• Ability to perform repetitious duties throughout the shift.
• Ability to memorize a considerable amount of information, and to be able to reference information not retained from written sources or from appropriate personnel.
• Basic knowledge of medical terminology preferred.
• Basic knowledge of third party payers preferred.
• General knowledge of time of service collection procedures preferred.
• Excellent communication skills (written and verbal).
• Ability to understand written and oral communication.

Additional Job Description

• Rotating holidays.
• Scheduled Weekly Hours 20.
• Shift Varied (United States of America).
• Exempt/Non-Exempt United States of America (Non-Exempt).