Senior Patient Access Specialist

About the role

The Senior Patient Access Specialist is responsible for performing admitting duties for all patients admitted for services at the hospital. They are responsible for performing these functions while meeting the mission and goals of the organization and all regulatory compliance requirements. The Representative will work within the policies and processes as they are being performed across the entire organization.

Responsibilities

• Performing admitting duties for all patients admitted for services at the hospital.
• Relaying incoming, outgoing, and inter-office calls.
• Assigning accurate MRNs, completing medical necessity/compliance checks, providing patient instructions, collecting insurance information, receiving and processing physician orders, and utilizing an overlay tool.
• Ensuring accounts are corrected through quality auditing and reporting systems.
• Pre-registering patient accounts prior to patient visits.
• Explaining general consent for treatment forms to the patient/guarantor/legal guardian, obtaining necessary signatures, and distributing patient education documents.
• Reviewing eligibility responses in insurance verification systems and selecting the applicable insurance plan code.
• Screens medical necessity using the Advanced Beneficiary Notice (ABN) software and distributing the ABN as appropriate.
• Distributing and documenting other designated forms and pamphlets.

Requirements

Employment Qualifications: Certified Healthcare Access Associate (CHAA) and/or Certified Revenue Cycle Representative (CRCR), Company Paid. Other Preferred Knowledge, Skills, and Abilities: 2 Year/Associates Degree, Specialty/Major: Healthcare administration, business administration, or related field, Minimum Years and Type of Experience: 2-3 years of experience in patient access or leadership role.

Qualifications

Comprehensive knowledge of patient insurance process for obtaining authorizations and benefits verification. Knowledge of Health Insurance requirements. Knowledge of medical terminology or CPT or procedure codes. Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.

Skills

Understanding of Revenue Cycle including admission, billing, payments, and denials. Understanding of Health Insurance requirements. Knowledge of medical terminology or CPT or procedure codes. Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.

Benefits

Comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs. Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement. Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Pay

This position pays between $18.65 - $19.90/hr. based on experience.

Schedule

This position is an onsite role at Valley - Outpatient Diagnostic Center in Winchester, VA.