Patient Access Specialist

Responsibilities

• 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.
• Obtains electronic signature for consent to treat and patient financial obligation.
• Provides excellent customer service and uses strong written/verbal communication skills.
• This position is the first impression of WVU Healthcare to the patient.
• 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.
• May complete managed care responsibilities in regard to obtaining pre-certification and authorizations.
• Prepares 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).
• May initiate 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.
• May initiate ERSD (end stage renal disease) screening.
• Identifies ESRD patients and obtains all pertinent information regarding coverage by SSI and documents in the registration/billing systems.
• May initiate Veterans Administration eligibility screening.
• Identifies all VA eligible patients and coordinated admission/treatment with VA and documents in the registration/billing systems.
• May initiate Black Lung SSI screening.
• Identifies all patients covered under Black Lung and documents in the registration/billing systems.
• May initiate 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.
• Documents in registration/billing system all information required on the MSPQ.
• Maintains confidentiality according to policy and HIPAA when interacting with patients, physicians, families, co-workers and the public regarding demographic/clinical/financial information.
• Provides to the patient information concerning insurance, payment of bills and hospital procedures.
• Consistently maintains current knowledge of major payer payment provisions.
• Performs medical necessity checks and completes Advanced Beneficiary Notice as needed.
• 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,