Patient Access Specialist 1
Patient Access Specialist 1
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Salary Not Disclosed
1 Vacancy
Job Description
Employment Type:
Full timeShift:
Night ShiftDescription:
GENERAL SUMMARY:Under limited supervision; determines need for and obtains authorization for treatment / procedures and assignment of benefits required. Provides information to patients concerning regulatory requirements. Provides estimated costs and patient responsibility facilitating collection of co-pay deductible and private pay balances. Responsible for the complete and accurate collection of patient demographic and financial information for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and checks-in patients and determines preliminary patient and insurance liability. Performs account analysis problem solving and resolution of patient account issues. Initiates billing and rebilling of accounts as appropriate.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Interviews patients and gathers information to assure accurate and timely claims submission.
Interprets information collected to determine and create comprehensive visit-specific billing records.
Determines need for and obtains authorization for treatment/procedures and assignment of benefits as required.
Maintains competency by participating in on site and external training opportunities.
Utilize skills gained from training sessions to improve and enhance their work processes and customer interactions.
Provides information to patients concerning hospital policies and regulatory requirements utilizing effective interpersonal and guest-relations skills.
Provides assistance to other Health System or physician offices staff regarding registration insurance verification and authorization requirements and processes. Determines appropriate payment required at point of registration (deposits co-pays minimum charges and non-covered services.)
Collects payment at time of registration or check-out.
Based on planned services provides estimated costs and patient responsibility for both procedural and complex services. Documents communication with patients related to estimates within the patient accounting record. Verifies procedural and diagnosis codes submitted by service departments and physicians to assure accuracy for claims submission and adjudication of reimbursement. Verifies insurance eligibility with payors. Determines benefits and ensures authorization requirement are met. Interacts with ordering practioner and patient to coordinate service and insurance requirements. Contacts patients to discuss eligibility and benefits and requirements specific to clinical services. Creates appropriate registration record.
Maintains the confidentiality of information acquired pertaining to patient physicians employees and visitors to Trinity Hospital.
Discusses patient and hospital information only among appropriate personnel in appropriately private places.
Behaves in accordance with the Mission Vision and Values of Trinity Health System.
Assumes responsibility for performance of job duties in the safest possible manner to assure personal safety and that of coworkers and to report all preventable hazards and unsafe practices immediately to management.
REQUIRED EDUCATION EXPERIENCE
Education:
Requires high school diploma or equivalent.
Experience:
One or two years related experience.
REQUIRED SKILLS AND ABILITIES
Demonstrated computerized system application experience.
Critical thinking and problem-solving skills.
Analytical ability to affective and efficiently resolve registration insurance and claims processing issues.
Demonstrated knowledge of revenue cycle processes and terminology.
Interpersonal skills to effectively communicate with patients team members clinical colleagues medical staff third party providers and external agencies and contacts.
Exceptional customer service skills and positive personality attributes.
Patience in dealing with ordinary arduous or emotional patients.
Use of telephones.
Our Commitment
Rooted in our Mission and Core Values we honor the dignity of every person and recognize the unique perspectives experiences and talents each colleague brings. By finding common ground and embracing our differences we grow stronger together and deliver more compassionate person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability veteran status or any other status protected by federal state or local law.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
