Patient Access Account Specialist

Now Hiring: Patient Access Account Specialist

Under the direction of the Patient Access Supervisor, the Patient Access Account Specialist supports the financial clearance of patient accounts for government and commercial payers prior to service. Responsibilities include insurance verification, authorization processing, benefit review, patient demographic documentation, and pre-service collections. This role ensures timely follow-up on authorizations for scheduled, urgent, and emergent procedures and admissions through the date of service or discharge. The Specialist must maintain a working knowledge of Medicare (CMS) guidelines and other regulatory requirements applicable to Patient Access, including HIPAA, EMTALA, and MSPQ compliance standards.

Type of Opportunity: Full time

Job Exempt: No

Job is based: Reverend Hugh Cooper Administrative Center

Work Shift: Days (United States of America)

Responsibilities:

• Verify insurance eligibility, benefits, and payer requirements to ensure accounts are financially cleared prior to service.
• Obtain, track, and follow up on authorizations for scheduled, urgent, and emergent procedures and admissions.
• Complete patient registration and accurately collect and document demographic, insurance, financial, and clinical information.
• Educate patients on insurance coverage and financial responsibility while collecting applicable patient balances.
• Maintain compliance with Medicare (CMS), HIPAA, EMTALA, MSPQ, and payer guidelines, ensuring accurate documentation and account resolution.

Qualifications:

• This role follows a hybrid schedule, Monday through Friday, 9:00 AM to 5:30 PM.
• High school diploma, continued education preferred
• External and Internal Non-Patient 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

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being 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, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Presbyterian Healthcare Services