Patient Access Specialist I

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, responding to customer requests, and analyzing and rectifying customer concerns.

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.
• Maintains a working knowledge of available information system capabilities and performs all system applications that are required.
• 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.
• Assists physicians and their office staff to expedite scheduling, pre-admission, Medicaid screening and pre-certifications on all accounts.
• Solves error and applicable Claim, DNB, and Patient WorkQueues.

Customer Service

• Greets all guests with a positive and professional attitude.
• 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.
• Works efficiently and accurately within designated time frames to ensure a continuity of information and cash flow.
• Contacts scheduled patients at home to obtain pre-admission information, explain financial policies, estimate self-pay balances, and obtain a promise to pay on or before admission/registration.
• Documents concise and understandable notes regarding all self-pay account collection activity, as well as each patient or guarantor interaction.
• Documents all efforts to collect patient account balances, other self-pay collection activities and referrals to Medicaid.
• Coordinates financial counseling activities with Admitting, Outpatient Registration, Emergency Registration, Utilization Review, Nursing, Social Services, and Patient Financial Services.
• 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.

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.