Patient Access Specialist (Insurance) - PRN |Weekends

Description Of Position

Under the direction of the Patient Access Supervisor, this employee promotes a caring and compassionate environment that allows Lake Charles Memorial Hospital to provide an individualized experience to our patients. This employee is devoted to promoting excellent patient and provider relations that encourage a lasting connection.

Responsibilities

• Knowledgeable of the LCMH Financial Assistance program and able to provide a clear definition of the program to all customers.
• Able to recognize when someone may need assistance and offer assistance without hesitation.
• Provides application and details on what information will be needed to process a complete application.
• Quantifies applicable patient portions on each patient and discusses financial obligations comfortably.
• Able to complete patient estimates.
• Knowledgeable of CPT and procedure codes and able to accurately complete estimates.
• Uses EPIC RTE on all applicable patients and only excludes those with Medicaid, Medicare, and a secondary insurance, and those qualifying for full coverage under financial assistance.
• Strives to meet cash collection goals.
• Knowledgeable about insurance processing and able to explain deductibles, co-insurance, co-payments, and how processing occurs.
• Clearly documents all actions on accounts to ensure the success of any employee who touches the account in any manner.
• Documents the name of the insurance company, phone number(s), website, and reference numbers given.
• Scans appropriate documentation to the patient's account for future reference.
• Pays close attention to detail to address pre-existing periods, policy riders, or low coverage policies prior to the procedure or notify financial counseling when patients are admitted as an emergent patient.
• Completes all scheduled accounts within a timely manner not exceeding 5 days prior to the scheduled date.
• Notifies physician’s office staff of authorization requirements timely to ensure authorization can be obtained 3 days prior to the procedure.
• Provides notification to management when an account has reached 3 days out and does not have an authorization so that management can assist if possible. Also keeps management updated daily until the day prior to the procedure to make a discretionary decision regarding the procedure being postponed.
• Mets acceptable productivity standards working a minimum of 55 accounts per day.
• Verifies benefits are active and quantifies patients' benefit levels including but not limited to: Deductibles, co-insurance, co-payments, lifetime maximum, yearly out-of-pocket, pre-existing, policy riders, and non-covered services.
• Sends timely notifications to all insurance companies of patients that have been admitted to the facility to meet notification requirements.
• Verifies correct patient type versus orders, ensures order has a status listed. Follows up with the physician’s office to obtain a corrected order when a status is not listed.

Requirements

• High School graduate or GED certificate.
• Previous work experience in healthcare or medical insurance environment preferred.
• Basic office and keyboarding skills and the ability to use computer, printer, fax machine, scanner, and calculator.
• Basic math skills for collection and reconciliation purposes.
• Proficient skills and understanding of Word and Excel.
• Ability to use multiple databases and hospital specific software.
• Interpersonal skills to interact effectively with patients from various backgrounds in a professional, enthusiastic, courteous, and caring manner.
• Appropriate phone etiquette.
• Complete understanding of time of service collections and collection goals.
• Basic knowledge of medical terminology and insurance/managed care program regulations.
• Ability to read, write, and speak intelligibly English.
• Ability to communicate with patients, family, peers, and medical personnel.
• Basic math skills and appropriate phone etiquette.
• Requires emotional stability and resilience.
• Must be adaptable to change, decisive, and demonstrate foresight.
• Exhibits organizational and leadership ability.

Qualifications

• Interpersonal skills to interact effectively with patients from various backgrounds in a professional, enthusiastic, courteous, and caring manner.
• Ability to deal with stressful situations and conflict resolution.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Skills

• Knowledge of LCMH Financial Assistance program.
• Ability to recognize and assist patients needing help.
• Ability to complete patient applications and provide necessary information.
• Ability to quantify patient portions and discuss financial obligations.
• Ability to complete patient estimates.
• Knowledge of CPT and procedure codes.
• Ability to use EPIC RTE and exclude certain patients.
• Ability to meet cash collection goals.
• Knowledge of insurance processing and ability to explain deductibles, co-insurance, co-payments, and processing.
• Ability to document actions on accounts and address pre-existing conditions.
• Ability to notify management of pending accounts and provide updates.
• Ability to complete scheduled accounts within a timely manner.
• Ability to verify benefits and quantify patient benefit levels.
• Ability to send notifications to insurance companies.
• Ability to verify patient types and statuses.

Benefits

• Opportunity to be part of a Great Place to Work organization.
• Emphasis on exceptional patient care and the well-being and professional growth of employees.
• Flexible scheduling options based on unit/department/service needs.
• Professional written and verbal communication and interpersonal skills required.
• Ability to handle stressful situations and conflict resolution.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Pay

N/A

Schedule

N/A

About the Role

Lake Charles Memorial Health System is more than a slogan; it's the care we provide our patients and the commitment to our community and our team members. As a nationally certified Great Place to Work, at Lake Charles Memorial Health System you will have the opportunity to be a part of an organizational culture that supports not only exceptional patient care but also the well-being and professional growth of our employees. Join us and be a part of a team where your contributions are valued, your growth is nurtured, and your success is celebrated.

Working at Lake Charles Memorial Health System

Working at Lake Charles Memorial Health System | Great Place To Work®