Patient Access Specialist Sr

Responsibilities

• Ensures the appropriateness of complex registration activity including scheduling, verifying patient demographic information, processing point of service payments, obtaining signatures for required consent paperwork, document imaging and following documentation standards to facilitate efficient patient access according to assigned protocol
• Ensures the appropriateness of complex patient access transactions including coverage eligibility, insurance verification, patient portion calculation and authorization requirement activity utilizing available systems and resources according to assigned protocol
• Possesses the ability to use analytical thinking, independent judgment, and clinical knowledge to adjust service area schedules and accommodate special requests from internal and external customers
• Accepts inbound phone calls from patients, physician offices, insurance carriers, etc. with the intent to resolve the concern immediately
• Collections patient payments and follows levels of authority to ensure financial clearance
• Documents all patient accounts activities concisely, including authorization and patient liability requirements
• Performs filing, data entry, and other duties as assigned
• Responds promptly to patient inquiries regarding pre-care services, policies, coverage, benefits and financial liability
• Utilizes multiple resources to resolve patient or payor inquiries while on the phone or preparing/reviewing patient accounts or prior authorization requirements
• Understands different payer regulations and can communicate effectively with patients regarding their coverage benefits and financial liability
• Acts as a liaison to resolve complex patient access and account issues, responds to questions on reimbursement and serves as a resource and systems expert for patient access specialists, including on-the-job training, and for performance improvement and appropriateness of complex patient access transactions
• Provides guidance, feedback and training to staff on multiple processes, payers and systems, and monitors assignments and assess productivity
• Handles all communication effectively, including telephone, email, and verbally with all departments and caregivers within the health system
• Initiates and coordinates the implementation of team-oriented process improvement initiatives for the department and organization
• Initiates and coordinates continuous quality improvement efforts, establishes goals with supervisors, tracks progress, and prepares data for presentation
• Interprets and maintains compliance with performance standards, federal and state regulations including EMTALA and HIPAA, policies, procedures, guidelines, and third-party contracts.

Qualifications

• 4 years of Patient Access operations activities (scheduling/registration/insurance) or related experience (billing, collections, accounts receivables)
• Previous experience in one of the following: scheduling, registration, insurance, billing, collections, and customer service in either a hospital or physician's office setting
• Preferred Job Qualifications: Bachelor's degree in related field or Healthcare Certification (AAHAM CRCS, HFMA CRCR, NAHAM CHAA) preferred
• Previous experience with Microsoft Office programs and experience with admission/discharge/transfer or billing/claims management software
• Previous experience with medical terminology, basic ICD 10 and CPT coding healthcare program reimbursement and methodologies
• Previous experience in 3+ of the following: scheduling, registration, insurance (including Medicare, Medicaid, and third-party regulations), billing, collections, and customer service in either a hospital or physician's office setting

About the Role

Join our team as a day shift, full time, Patient Access Specialist Sr at INTEGRIS Health Baptist Medical Center in Oklahoma City, OK. Get to Know Your Team INTEGRIS Health, Oklahoma’s largest not-for-profit health system, is seeking a dedicated caregiver to join us in our mission to partner with people to live healthier lives. Benefits of being an INTEGRIS Health caregiver include front-loaded PTO, medical benefits through the extensive INTEGRIS Health network, financial assistance for continued education, 24/7 mental health support and more. Take the first step toward growing your career by joining us.