Patient Access Specialist

Job Title

Completes accurate scheduling, pre-registration, financial screening and pre-service collection calls for tests/procedures performed at Blanchard Valley Health System.

Job Duties/Responsibilities

Efficiently schedules patients for requested services with exceptional accuracy via phone orders, faxed orders, Patient Portal and other wait lists. Educates all customers (office staff/patients) on the preparation for upcoming testing.

PreRegisters patients. Using all Insurance verification tools, confirms active insurance coverage. Uses available reports/queues to address insurance discrepancies prior to service.

Completes Medical Necessity review for all Medicare patients ensuring that an ABN is printed or needed DX obtained.

Utilizes the electronic patient self-preregistration tool to reconcile demographic and insurance information the patient has submitted prior to their date of service.

Run the financial assistance screening tools to provide assistance including HCAP, Charity, and Medicaid when applicable. Sends applications to the appropriate care area.

Scrubs all orders for completeness and accuracy and scans to the appropriate category in document imaging system.

Provides the patient an estimated cost of their procedure (including Good Faith Estimate info to appropriate patient populations) and requests pre-payment and self-pay (remaining balance) payments. Informs patient of all payment options.

Monitors all procedures for financial responsibility and pre-payment at all BV locations. Maintains reports/records. Gathers and documents patient deductible, out of pocket coinsurance and copay information and reviews all bad debt accounts.

Practices effective phone communication with customers (i.e. uses customer name, listening to needs and keeping a positive tone of voice). Has a strong focus and commitment to Service Excellence and Patient Satisfaction.

Acts as liaison between the facility and patient/family to resolve problems and/or address complaints.

Participates in a variety of unit and hospital educational programs to maintain current skills and competency levels. Participates in and fully supports new hire and other department training and shadowing. Provides a positive learning environment and compassionate mentoring.

Actively adheres to all policies of the department and organization. Is an active participant in department meetings, is engaged in process improvement initiatives and informs department Supervisor/Manager of inconsistencies that exist in the electronic health record.

Performs all duties and responsibilities in a manner consistent with and supportive of the mission, vision and values of Blanchard Valley Health System.

Required Qualifications

High School diploma or GED equivalent.

Data entry and/or PC experience

Medical terminology coursework or knowledge

Exceptional customer service skills

Maintains confidentiality at all times

Ability to work remote and attend onsite meetings as needed

Ability to work at the computer for long periods. Skilled in key board skills. Ability to use the telephone to respond to customers, and the ability to use the computer and telephone simultaneously.

Positive service-oriented interpersonal and communication skills required

Individual must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patient served on his/her assigned unit/department. The individual must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient status. Must be able to interpret the appropriate information needed to identify each patient's requirements relative to their age-specific needs and to provide the care needed as described in the area's policies and procedures.

Preferred Qualifications

Minimum of two years Registration, medical office or hospital experience

Associates degree in Healthcare related field

Knowledge of CPT Coding, ICD 9 Codes, and Medicare Reimbursement Issues.

Physical Demands

This position requires a full range of body motion with intermittent bending, squatting, kneeling, and twisting. This position requires an individual to lift up to 20 pounds occasionally and push patients in wheelchairs (100-350 lbs). The individual must have excellent eye/hand coordination to operate various office machines. This position requires corrected vision and hearing in the normal range.