Patient Access Specialist

Role Overview

• Responsible for performing admitting duties for all patients admitted for services at the hospital.
• Responsible for assigning accurate MRNs, completing medical necessity / compliance checks, providing proper patient instructions, collecting insurance information, receiving and processing physician orders, and utilizing a overlay tool while providing excellent customer service as measured by Press Ganey.
• Operates the telephone switchboard to relay incoming, out-going and inter-office calls as applicable.
• Adhere to policies, and provide excellent customer service in these interactions with the appropriate level of compassion.
• Responsible for the utilization of quality auditing and reporting systems to ensure accounts are corrected.
• Conducts audits of accounts and assures that all forms are completed accurate, timely to meet audit standards and provides statistical data to Patient Access leadership.
• Responsible for the pre-registration of patient accounts prior to patient visits. This may include inbound and outbound calling to obtain demographic, insurance, and other patient information including the patient financial liabilities including collecting point of service collections as well as past due balances including payment plan options.
• Explains general consent for treatment forms to the patient/guarantor/legal guardian, obtains necessary signatures and witnesses name.
• Explains and distributes patient education documents, such as Important Message from Medicare, Important Message from Tricare, Observation Forms, MOON form, Consent forms, and all forms implemented for future services.
• Reviews eligibility responses in insurance verification system and appropriately selects the applicable insurance plan code, enters benefit data into system to support POS (Point of Service Collections) and billing processes to assist with a clean claim rate.
• Responsible for accurately screening of medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of test by Medicare and distribution of the ABN as appropriate.

Requirements

• 1+ years of customer service experience
• 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.
• High School Diploma/GED
• CRCR Required within 6 months of hire (Company Paid)

Benefits

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement