Patient Access Specialist

Patient Access Representative

Has overall responsibility for day-to-day operations of patient access, including scheduling functions, while providing excellent customer service. These duties will be conducted in accordance with existing MLMC policies and procedures.

Essential Duties and Responsibilities:

1. Entering patient information into Practice Management system (PM), electronically verifying patients insurance and/or determining eligibility for sliding fee program and determine the amount of co-pay, and inputting insurance payer codes and information. Verifying existing patient's demographics and insurance; updating information as necessary.
2. Responsible for making correct billing decisions by ensuring the correct demographics, and insurance coverage are entered on the patients account, and processed correctly.
3. Checking in patients; collecting co-pays and any fees due, updating MLMC forms as necessary, notifying clinical team of patient's arrival through the Electronic Health Record.
4. Answering phones, routing calls appropriately, and taking messages and documenting in the Electronic Health Record.
5. Scheduling patients' appointments for all providers, nurses, lab, by phone or in person utilizing MLMC appointment guidelines. Routing appointment requests to clinical triage, when necessary.
6. Checking out patients, scheduling follow-up appointments when appropriate.
   • Verifying patient has received any paperwork before leaving: receipts, appointment reminders, and patient plans.
   • Collection of co-pay and any fees due; while keeping record of payments received on patients account through Practice Management (PM). Daily posting of payment batch.
   • Adding recall plans to patients when appropriate.
7. Responsible for managing individual cash drawer, keeping amount accurate according to the Financial Policy.
8. Interpreting and understanding of the patient's financial transactions, responding to patient questions and inquiries; working in conjunction with Billing Specialists for any extensive patient inquiries. Maintain an understanding of the revenue cycle.
9. Provides excellent patient-centered customer service while being friendly and courteous to all employees and patients; can handle multiple tasks at once and has the ability to compassionately and empathetically care for patients.
10. Upholds the Code of Ethics and mission of Mountain Laurel Medical Center by conducting professional activities with honesty, integrity, respect, fairness, and good faith in a manner that will reflect well upon the organization.
11. When instructed by supervisor, entering monthly provider schedules in computer, filing miscellaneous paperwork in patients' medical records, assisting with explanation of insurance coverage to patients.
12. Participate in continued education to keep abreast of changes in insurance plans, coverage limitations, medical services and regulations associated with working in a health care center.
13. Miscellaneous duties: Sign for deliveries, attend weekly staff meetings, and other duties as assigned.

Core Value Statements:

Patient Focused - The patient comes first and is central to all decision making.

Respect - Treat all patients and staff the way you expect to be treated.

Accountability - Each employee owns their actions, and expects the same from all others.

Teamwork - It is necessary to work together in a supportive manner to achieve common goals.

Continuous Improvement - Stay committed to the pursuit of excellence, always finding ways to adapt and improve.

Integrity - Always do the right thing.

Requirements:

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills and ability required. Must be able to effectively communicate with staff and patients, delivering exceptional customer service skills. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Working in the patient information office may expose this position to sensitive and/or confidential information that must be held in confidence. Candidates must demonstrate awareness and sensitivity to the needs of the diverse population served by MLMC.

Education and Experience:

A high school diploma or GED is required. Three (3) years related experience and/or training or equivalent is necessary, preferably in a medical related setting. A combination of education and experience will be considered.

Computer Literacy:

Knowledge of basic computer software and the willingness and ability to learn electronic medical records software.

Insurance Knowledge:

Vast understanding of the different types of insurances and the knowledge and ability to distinguish the differences in coverage, charges and co-pays; essentially becoming an expert. Understanding and ability to interpret patient's financial record and the impact on the revenue cycle.

Work Record:

A demonstrated work record showing good attendance, punctuality, dependability and the ability to work well with supervisors and coworkers as part of a team effort is essential. A medical office setting is an environment that requires the ability to relate to all types of people while always maintaining a professional demeanor.

Language Skills:

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals is essential. Ability to write routine reports and correspondence, and the ability to speak effectively to patients, co-workers and the public at large is paramount.

Mathematical Skills:

Must have the ability to calculate figures and amounts such as sliding fees, discounts, interest, proportions and percentages along with mathematical accuracy and attention to detail are essential skills for this position.

Reasoning Ability:

Must be able to demonstrate the ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Team Work:

An essential element is the ability to work and interact effectively and positively with other staff members to build and enhance teamwork in a patient centered team based model of care and in the overall MLMC organization; team engagement is a must to be successful in this position.

Sensitivity to the Needs of Special Populations:

Must be able to demonstrate the ability to understand and respond appropriately, effectively and sensitively to special population groups served by MLMC. Special population groups include those defined by race, ethnicity, language, age, sex, sexual orientation, economic standing, disability, religion, etc.

Understanding of HealthCare laws and Regulations:

Must have the ability to follow HIPAA guidelines as well as an understanding of policies and procedures regarding medical records put in place by the Federal Government.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to drive, sit, handle papers, type and operate computer equipment; reach with hands and arms; talk, see and hear. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Work Environment:

Work is performed in a typical outpatient medical clinic environment. Some local trips by automobile may be required (i.e., Post Office, hospital office supplies, etc.). Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.