Patient Access Specialist I (various clinics) Augusta/Aiken

How would you like to work in a place where your contributions and ideas are valued A place where you can serve with compassion pursue excellence and honor every voice At Wellstar our mission is simple yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of whats possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry and in peoples lives.

Work Shift

Job Summary:

This job is typically the first point of contact and must ensure a pleasant experience for patients and visitors.
Interviews patients and/or their representatives to obtain complete and accurate demographic financial and
insurance information required for billing and collecting patient accounts. Conducts intensive screening of all
Medicare Medicaid and managed care patients for pre-certification requirements and provider service eligibility
prior to registration. Obtains all necessary customer consents/attestations.
Coordinates the collection of all estimated patient liabilities including co-payments and unmet deductibles.
Verifies insurance benefits and coverage for inpatients and outpatients. Responds to customer requests and
answers questions regarding various service and account information. Analyzes and rectifies customer concerns
using established procedures. Uses computer to access and/or update customer records.
Verifies and posts transactions. Follows established procedures for processing receipts cash etc. Sorts and files
various documents. Assists with general hospital information and directions to departments within and outside
of the WHS facility. Establishes financial arrangements to reduce financial risk for WHS helping to ensure that
WellStar is reimbursed for its services.

Core Responsibilities and Essential Functions:

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 patients 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 Work Queues.
Customer Service
Greets all guest with a positive and professional attitude.
Receives patients valuables for safekeeping in the hospital safe.
Answers incoming phone calls and follows through with requests made.
Maintains courteous and cooperative working relationships with WHS management patients
physicians other professional contacts and the general public. Demonstrates ability to
tactfully handle difficult situations.
Presents a well-groomed and professional image in coordination with dept/ hospital dress
codes.
Expected Performance Behaviors and Results:
The WellStar Experience (Must demonstrate a commitment to Service Excellence by):
Creating first impressions memorable moments and impressions that fulfill the expressed
and unexpressed wishes and needs of patients and family members.
Valuing patients and family members as partners in their care.
Having world-class processes in place.
Delivering high-touch care that is reliable responsive and coordinated.
Focusing on constant innovation and creating improvements.
Celebrating our diversity with sensitivity and understanding.
Embracing the idea that we are all owners of our health system.
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 guarantors 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 Work Queues.
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.
Performs other duties as assigned
Complies with all Wellstar Health System policies standards of work and code of conduct.

Required Minimum Education:

• High School Diploma Other or GED Other or Associates General-Preferred

Required Minimum License(s) and Certification(s):

All certifications are required upon hire unless otherwise stated.

Additional License(s) and Certification(s):

Required Minimum Experience:

Minimum 1 year in healthcare or institutional (corporate) work setting Required and

Required Minimum Skills:

Computer/data entry experience.
Ability to communicate with various members of the healthcare team.
Effective communication skills (both written and verbal) attention to detail self-directed and a positive attitude are essential.
Effective problem solving and critical thinking skills.
Working knowledge of patient registration systems and intermediate Microsoft Office Suite are preferred.
Epic experience preferred.
Patient Access Services (PAS) Operations Onboarding Training followed by a minimum passing scoreof on final exam within 45 days of hire. Staff who
do not pass will no longer meet the minimum requirement and will subsequently have the option to meet with the Talent Acquisition Specialist to assess other positions available within the health
system.
PAS employees who successfully complete the PAS onboarding exam will have the option to progress through enrollment to the WHS Enterprise
Membership - HFMA Certification program subject to PAS leadership approval

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