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 coordinating the collection of all estimated patient liabilities.

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 patient’s 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.
• Makes corrections and updates patient account information in computer.
• Documents thorough explanatory notes on patient accounts, concerning any non-routine circumstances, clarifying special billing processes.
• Maintains a working knowledge of available information system capabilities and performs all system applications that are required.
• Understands and applies WHS philosophy and objectives, and PAS policies and procedures, as related to assigned duties.
• 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.
• Aids physicians and their office staff to expedite scheduling, pre-admission, Medicaid screening and pre-certifications on all accounts.
• Solves errors and applicable Claim, DNB, and Patient WorkQueues.

Customer Service

• Greets all guests with a positive and professional attitude.
• Receives patients’ valuables for safekeeping in the hospital safe.
• 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.
• Refers patients/guarantors to sources of outside funding assistance, as needed.
• 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.
• Interviews all inpatients and select (self-pay) outpatients at time of registration, or at least within 24 hours of admission, to verify complete insurance and financial information, explain financial policies, and collect the estimated self-pay balance.
• 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.
• Identifies and resolves Payor Denials as indicated.

Required Minimum Education and Experience

• High school diploma.
• Minimum 1 year in healthcare, or institutional (corporate) work setting.

Required Minimum Skills

• Computer/data entry experience.
• Ability to communicate with various members of the healthcare team.
• Effective communication skills (both written and verbal), attention to detail, self-directed and a positive attitude are essential.
• Effective problem solving and critical thinking skills.
• Workable knowledge of patient registration systems and intermediate Microsoft Office Suite are preferred.
• Epic experience preferred.

Required Minimum Certifications

• Patient Access Services (PAS) Operations Onboarding Training followed by a minimum passing score of 90% on final exam within 45 days of hire.

Preferred Certifications

• WHS Enterprise Membership - HFMA Certification program, subject to PAS leadership approval.