Patient Access Associate

Patient Access Associate I

The Patient Access Associate I is responsible for the patient registration process, general admissions, and uninsured/underinsured procedures. This position verifies third party payer accounts, pre-authorization and/or pre-certification requirements. The Patient Access Associate I communicates and collaborates with Patient Access team members and other ancillary departments as needed. The Patient Access Associate I is responsible for scheduling Telehealth visits at Hammonton SED via the In Touch Solo scheduling platform.

The Patient Access Associate I will be knowledgeable of state and federal government funding programs such as Medicare, Medicaid, TRICARE/CHAMPUS, Workers' Compensation; No Fault Auto, and commercial insurance payers. The Patient Access Associate I will be knowledgeable of billing and reimbursement guidelines and methodologies for state and federal government and non-government payers; insurance terminology; basic medical terminology, EMTALA, HIPAA privacy, and compliance practices.

The Patient Access Associate I is responsible for verifying diagnosis codes, completing medical necessity checks for Medicare, completing and identifying patient liabilities including estimates for self-pay, copays and deductibles. The Patient Access Associate I must have basic knowledge of ICD-10 in order to ensure accurate diagnosis entry for reimbursement.

The Patient Access Associate I will perform duties after an eight week training program under the supervision of the Patient Access Leadership Team and Revenue Cycle Quality & Assurance Training Team. This position is a customer service champion responsible for delivering great customer service at each entry point throughout the health system. This position is also responsible for patient throughput, established wait times and turnaround (TAT) times for all Patient Access areas along with aiding in the achievement of top box customer service scores for each respective Patient Access site.

The Patient Access Associate I must pass annual recertification with score of 90% or better. The Patient Access Associate I can perform job duties based on department procedure and protocol; may require direct oversight. Attends all required trainings and in-services and passes all competency tests associated with the in-services. The Patient Access Associate I need to become certified in the NJ Family Care Presumptive Eligibility process within the first six months of employment.

This position maintains a high accuracy rate of 98% or higher and established productivity rates for Key Performance Indicators (KPI) such as cash collections wait and TAT times, pre-registration and registration productivity.

The Patient Access Associate I must achieve Valued Contributor or above on their annual evaluation with no written disciplinary documents on file. The Patient Access Associate has the opportunity for advancement to Patient Access Associate II if all of the above requirements are satisfied and the incumbent has been in the role for one year. In order to advance via the Patient Access Career Path, the Patient Access Associate I must complete the coursework and Litmos Revenue Cycle Certified Professional I or HFMA Certified Revenue Cycle Representative certification. The Patient Access Associate I must pass the annual recertification with a minimum score of 95%. This requirement is expected to be maintained every year after the upgrade. Staff member will be required to re-take training and exam until they obtain the appropriate grade or disciplinary action will be taken in regards to performance.

The Patient Access Associate I must achieve an evaluation rating of Valued Contributor the year of consideration and every year after. If the valued contributor rating is not achieved in the following years, an action plan will be put in place to remediate the staff member back to Valued Contributor and no further considerations for the career path program will be allowed until the staff member formally achieves valued contributor on their next annual evaluation.

This position supports organizational goals by providing high level, quality customer service, participating in performance improvement efforts, demonstrating a commitment to teamwork and cooperation while verifying and preparing all patient accounts for inpatient and outpatient billing in order to maximize payment for Hospital and Clinic services from all sources. The Patient Access Associate I may be responsible for additional duties as assigned with respect to the Patient Access job scope.