Patient Access Associate I (Full-time, 3:00pm-11:30pm)

Job Title

Responsible for communicating with patients, families, physicians, quality review, and insurance companies to obtain information and insurance verification to assure quality patient care and payment of hospital accounts.

This includes greeting patients, providing information, answering phones, registering outpatients and/or inpatients, coding lab accounts, and entering orders as required. Additional responsibilities include obtaining all demographics, insurance information, appropriate codes, and authorizations from insurance companies, patients (or their representatives), and physicians in a courteous and efficient manner for billing. Other duties pertinent to optimal customer service, patient flow, and efficient staff utilization are also expected. Maintains a professional and courteous behavior to ensure a positive image within the community served and to promote customer satisfaction. May perform bed assignments, assign physicians, and schedule patient appointments. Provides other registration, clerical, and billing support as required. Reviews patient accounts and collects payments at time of service as well as reviews past due accounts for monies owed; refers patients to patient advocacy for any additional financial assistance.

Primary Duties and Responsibilities

• Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.
• Greets all patients, family members, and visitors into the department/service area. May screen visitors and issue visitors pass. Alerts nurse when patients present with any complaints that could be perceived as acute or life threatening. Places ID band on each patient.
• Interviews patients, families, and outside sources to obtain complete and accurate demographic and financial information. Inputs data into system for registration, billing, and patient tracking.
• Ensures that all necessary questionnaires and specific forms are completed according to predetermined requirements by government or regulatory agencies or hospital policies. Completes ABN process through registration system as needed explains to patient as required. Completes Medicare Secondary Payor Questionnaire (MSPQ) as required. Distributes Medicare Letter to inpatients.
• Confirms coverage using online electronic verification systems; selects appropriate insurance codes and may obtain authorizations by utilizing online electronic verification system or other resources such as HDX EVS or Blueline; follow up on insurance authorizations and referrals if needed.
• Is proficient in the use of multiple systems such as Teletracking, SMS, Cerner, Amnion, and IDX.
• Explains regulatory financial requirements to the patient or responsible party and collects deposits and deductibles as required. Reviews past due accounts at the time of service collects payments; refers patients to patient advocacy for any additional financial assistance.
• Follows established cash reconciliation policy guidelines and may complete daily.
• Comprehends and adheres to HIPAA and Red Flag rules.
• Adheres to the MedStar Health Financial Assistance Policies and Procedures.
• Utilizes Managed Care Handbook for plan requirements of contracted services or if service is carved out.
• Maintains flexibility in learning all areas of Patient Access which may include bed control, scheduling patient appointments, and clerical support. Performs Admitting functions in a timely manner. Works additional time as requested when staffing problems occur.
• Performs scanning functions into the document imaging system and audit control of records with 98% accuracy.
• Provides administrative support in various areas of the respective Patient Access departments where needed.
• Maintains accurate documentation.
• Completes mandatory training (SITEL) within defined time frame.
• Participates in meetings and on committees and represents the department and hospital in community outreach efforts.
• Participates in multi-disciplinary quality and service improvement teams.

Minimal Qualifications

• High School Diploma or GED required
• Knowledge of medical terminology preferred

Experience

• Customer service experience required and
• Previous healthcare experience preferred

Knowledge Skills and Abilities

• Excellent verbal and written communication skills.
• Working knowledge of various computer software applications and basic computer skills preferred.
• Demonstrates dependability; critical thinking, self-management, initiative, creativity, and problem-solving abilities to improve the quality and efficiency of the department.
• Ability to perform in a high-pressure environment and deal effectively and professionally with a diverse population.

This position has a hiring range of USD $18.70 - USD $32.72 /Hr.