Patient Access Specialist

Patient Access Specialist

Requirements

• High School Diploma/G.E.D. – required
• 3 – 5 years experience in a hospital or physician office – required
• Computer skills (High proficiency)
• Insurance knowledge regarding payer contract interpretation including Authorization Requirements and Setting of Care (High proficiency)
• Proven customer service skill with ability to exceed expectations
• Ability to multi-task in stressful and high patient volume unit; must be able to manage pressure of very tight timeframes to execute task
• Ability to learn in classroom setting; utilizing resources
• Ability to remain composed under pressure
• Ability to review information and draw appropriate conclusion
• Good judgement and ability to be resourceful to problem solve; escalate issues as needed
• Team minded work ethic
• Demonstrated ability interpret patient’s insurance benefits and apply the applicable contractual obligations
• Critical thinking ability regarding issues with financially securing payment
• Ability to discuss sensitive concepts with patients regarding financial obligations
• CHAA – Certified Healthcare Access Associate upon hire or acquired within 2 years of hire within 1-1/2 Yrs – required

Responsibilities

• Responsible for creating encounters in ADT representing service patient is receiving
• Responsible to discern demographic and insurance information to ensure and accurate registration
• Responsible to interpret information received from Insurance Payer regarding patient’s eligibility and financial responsibility
• Responsible to discuss financial obligation of patient and collect via cash, credit card or check
• Responsible to explain regulatory forms and answer questions from patient; obtain signatures accordingly
• Responsible for scanning or managing online form template to maintain the Electronic Health Record
• Comprehend Federal, State, Third Party Payer regulations as it pertains to a hospital registration
• Ability to work in multiple systems during a telephone call or patient facing interaction to complete an accurate registration and support clinical workflow
• Responsible for review of services being rendered to ensure the appropriate setting of care has been assigned by the physician’s office; if not, physician staff will be advised of the contractual or regulatory expectation warranting a change of setting of care
• Ability to respond to requests for estimates for service being rendered or expected to be rendered
• Contact patient if issues or data missing impeding ability to financially secure encounter
• Responsible for securing encounters with extremely tight timeframes due to late booking of service
• Access Center/Birthplace ONLY: Responsible for the timely and accurately completed death certificate
• Access Center/Birthplace ONLY: Work in conjunction with Nursing Leadership for the appropriate bed placement for patients in the Emergency Department, Recovery Room, Cardiac Catheterization Lab, Direct Admits from Home, Transfers from other facilities
• Access Center/Birthplace ONLY: Multi-task of real time needs for bed placement and monitoring discharges and new reservation bed needs
• Apheresis and Infusion team ONLY: Responsible for securing payment for High Cost Apheresis and Infusion therapies; applying dosing, frequency of service is a critical component of financially securing service.

Preferred Qualifications

• Associate’s Degree – preferred