Patient Access Account Specialist I
Patient Access Account Specialist I
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Job Description
Overview
Now hiring a Patient Access Account Specialist IAdmitting
Under the direction of the Patient Access Supervisor the Patient Access Account Specialist I provides basic functions to financial clear patient accounts for government and commercial accounts prior to the date of service. Performs basic financial clearance functions including insurance verification authorization collection and documentation of patient demographics benefit analysis and preservice collections. The Patient Access Account Specialist I will ensure follow up on authorizations for scheduled and Urgent/Emergent procedures and admissions until date of service or discharge for admissions. The Patient Access Account Specialist I must possess a basic knowledge of Medicare (CMS) guidelines as well as other Compliance Regulatory guidelines applicable to Patient Access to include HIPAA EMTALA and CMS guidelines of MSPQ. The Patient Access Account Specialist (PAAS I) monitors work queues for financial clearance and missing authorizations ensuring a payment source is identified and secured and there is a clean claim for billing. The Patient Access Account Specialist I acts as resource to all employees within Patient Access. The Patient Access Account Specialist I is responsible for providing the highest level of customer service to patients ancillary departments and payers when financially clearing accounts. The PAAS I will work with ancillary departments to ensure the procedures scheduled and authorized meet payer requirements. The Patient Access Account Specialist I provides coverage to other areas and hospitals as needed to minimize overtime and guarantee the patients receive services as needed without registration delays.
How you belong matters here.
We value our employees differences and find strength in the diversity of our team and community.
At Presbyterian its not just what we do that matters. Its how we do it and it starts with our incredible team. From Information Technology to Food Services and beyond our nonclinical employees make a meaningful impact on the healthcare provided to our patients and members.
Why Join Us
- Full Time Exempt: No
- Job is based Rev Hugh Cooper Admin Center
- Work hours: Days
- Benefits: We offer a wide range of benefits including medical wellness program vision dental paid time off retirement and more for FT employees.
Ideal Candidate:
2 years of work experiences in healthcare setting within Patient Access and/or billing plus strong customer service background.
Qualifications
- High school diploma continued education preferred
- External and Internal NonPatient Access Candidates: Pass Patient Academy with passing score of 85 or higher
- Previous completion and passing of Patient Access Advocate II and III Advancement test.
- A minimum of 2 years of work experiences in healthcare setting within Patient Access and/or billing plus strong customer service background.
- Strong knowledge and understanding of insurance and financial processing of accounts.
- Proficient in EPIC ADT system
- Specialty Certifications: CHAA CHAM or other industry equivalent certification preferred
- Pass annual competency exam for all areas of responsibility.
- Requires general knowledge of the customer encounter process which may include registration contract requirements and coordination of benefits.
- Knowledge in Microsoft Office Products.
Responsibilities
- Achieve exceptional patient experience for patients and patient families by using CARES AIDET and EPE tools.
- Ability to manage conflict and appropriately request the help of a supervisor when needed.
- Implement PROMISE and CARES behaviors in every encounter.
- Educates patients for whom they speak regarding insurance benefits and liabilities.
- Ensures accounts are financially cleared prior to date of service to alleviate patient concerns over hospital financial matters
Encounter Components: - Performs the patient registration process. Manage the accurate collection of patient data which includes but is not limited to;
- Obtain/confirm and enter demographic and other financial and clinical information necessary for final clearance of scheduled accounts.
- Review Urgent/Emergent admission accounts for notification financial clearance and authorization predischarge.
- Obtain missing insurance information to include policy number group number date of birth and insurance phone number if not already identified in account.
- Verify insurance for eligibility and benefits using online electronic verification system or by contacting payer directly.
- Review and process work queues related to Patient Access previsit or urgent/emergent admissions per department guidelines.
- Review of accounts falling within the work queues to ensure the insurance information contains accurate policy ID#s Group Name and Numbers Subscriber information Authorization numbers as well as correct payer and Coordination of benefits prior to date of service.
- Maintain ongoing knowledge of authorization requirements and payer guidelines.
- Maintain a proficient knowledge of Medicare (CMS) guidelines as it relates to admissions and outpatient services. Ensuring compliance with admissions forms benefit entitlement verification and billing requirements
- Ensure accurate completion of MSPQ prior to date of service.
Benefits
All benefitseligible Presbyterian employees receive a comprehensive benefits package that includes medical dental vision shortterm and longterm disability group term life insurance and other optional voluntary benefits.
Wellness
Presbyterians Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your wellbeing. Earn gift cards and more by taking an active role in our personal wellbeing by participating in wellness activities like wellness challenges webinar preventive screening and more.
Why work at Presbyterian
As an organization we are committed to improving the health of our communities. From hosting growers markets to partnering with local communities Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients members and the communities we serve. We are locally owned notforprofit healthcare system of nine hospitals a statewide health plan and a growing multispecialty medical group. Founded in New Mexico in 1908 we are the states largest private employer with nearly 14000 employees including more than 1600 providers and nearly 4700 nurses.
Our health plan serves more than 580000 members statewide and offers Medicare Advantage Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drugfree and tobaccofree employer with smoke free campuses.
Maximum Offer for this position is up to
Compensation Disclaimer
Required Experience:
Unclear Seniority
Employment Type
Full-Time
