Full-Time Patient Access Specialist I @ Marietta

Responsibilities

Quality/ Safety:

• Receives requests for reservations (patient scheduling) from physicians’ offices and makes the necessary pre-admission arrangements, referring to lists of dates allotted for scheduling, and advising physicians’ office staff of unavailable dates.

• 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.

• Obtains new medical record numbers for newborn admissions and other new patients.

• 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. Understands the admission, outpatient and emergency registration process.

• 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.

• Assists physicians and their office staff to expedite scheduling, pre-admission, Medicaid screening and pre-certifications on all accounts.

• Resolves error and applicable Claim, DNB, and Patient WorkQueues 

Budget/Financial:

• Attempts to collect the estimated self-pay balance of all inpatient, outpatient and ER accounts, at the earliest possible collection control point.

• Monitors in-house accounts and attempts to make financial arrangements with guarantors for payment of their self-pay balances in full, prior to discharge, or within ten working days thereafter.

• Completes financial evaluation forms to document guarantors' income, expenses, assets and liabilities.

• Identifies those patients without adequate insurance coverage. Makes personal contact with patient or guarantor to determine guarantor's ability to pay non-covered charges, as well as to determine potential eligibility for financial assistance programs (namely Medicaid).

• 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.

• Responsible for completion of appropriate error/issues in WorkQueues.

• Identifies and resolves Payor Denials as indicated
   

General:

• Observes work hours and provides proper notice of absences, tardies work schedule changes.

• Attends select departmental meetings at the request of WHS Management.

• Completes monthly, quarterly, and annual mandatory training as required.

• Performs other duties as assigned.