Patient Access Specialist I

General Summary

Under the supervision of the Patient Access Supervisor and Team Lead, the Patient Access Specialist I (PAS I) performs complete and accurate registration and admissions functions to provide information for continuity of care and revenue cycle efficiency. The PAS I is an entry level position with the responsibility to obtain and verify demographic, insurance, and eligibility information during the registration process including point of service payments. Provides payment estimates for out-of-pocket costs. In this role the PAS I is assigned to one department/location. The PAS I must demonstrate competence in each essential duty to become eligible for the PAS II position. A minimum of one-year patient registration experience in the assigned department is required for consideration for PAS II.

Responsibilities

• Customer Service; meets the needs of the patient/patient representative by using clear and respectful communication while obtaining necessary information.
• Timely and precise completion of each registration, following all department processes and procedures.
• Must verify that all demographic and insurance information is accurate; utilizes Epic, payer websites or telephone for insurance verification.
• Obtain current copies of insurance cards and photo identification.
• Secures patient signatures for required forms.
• Enter data related to procedures, tests, and diagnoses (when applicable).
• Determines the need for medical necessity and follows the advanced beneficiary notice process when appropriate based on pre-established guidelines.
• Obtains and verify the accuracy of physician orders for tests and procedures to minimize risk to hospital reimbursement.
• Identify the patient using two factor identification.
• Complies with EMTALA regulation when creating the quick registration account (when applicable).
• Ensure authorizations (pre-certifications, prior authorization, referrals) are obtained prior to service, as applicable.
• Notify supervisor of any insurance authorization issues.
• As appropriate, completes Medicare Secondary Payer questionnaire without errors to support compliance with CMS policies.
• Perform point of service collections: Responsible for meeting monthly collection goals, having financial conversations with patients as it relates to their co-payments, deductibles, co-insurance, deposit amounts and outstanding balances.
• Documents payments/actions in the EHR and provides the patient with a payment estimate (when applicable).
• Follows cash drawer balancing procedures, as appropriate, reconciles payments against deposit totals.
• Review and resolve account errors in assigned work queues.
• Maintain qualitative and quantitative individual and team performance targets.
• Responds to disaster and mass casualty situations in a calm and appropriate fashion.
• Maintains and understands the emergency management processes and procedures specific to that unit.
• Adheres to department and system policies.
• Interact with co-workers, visitors, and other staff consistent with the Bayhealth values.
• Scheduling (as applicable) – may need to schedule appointments, following procedures and protocols.
• Assist patients with referral needs in obtaining additional appointments with specialists, and insurance approval authorization for additional visits.
• Patient flow (as applicable) - maintain efficient patient flow in the registration and check-in process.
• Accurately complete reception duties in accordance with policies.
• All other duties as assigned within the scope and range of job responsibilities.

Required Education, Credential(s) and Experience

• Education: High School Diploma or GED
• Credential(s): None Required
• Experience: One (1) year in a customer service role.

Preferred Education, Credential(s) and Experience

• Education: Associate Degree in Business Administration or related field
• Experience: Experience in healthcare or medical office environment. Knowledge of medical terminology.

Pay

Salary range: $17.40 - $26.10 hourly

Benefits

• Generous Paid Time Off and Paid Holidays
• Matching 401(k)/403(b) Plans
• Excellent Health, Dental, and Vision
• Disability and Life Insurance options
• On Site Child Care
• Educational Reimbursement
• Health Care and Dependent Care Flex Spending Accounts
• Array of Voluntary Benefits to include Critical Care Coverage and more

Schedule

Full Time 80 Hours, Day/Evening shift

Location: Outpatient Rehabilitation Center