Lead Patient Access Specialist

Job Title

Patient Access Representative

Job Description

The purpose of this position is to serve as a liaison between patient/family, payers, Patient Financial Services, and other health care team members. You'll be asked to facilitate patient tracking and billing by obtaining/verifying accurate and complete demographic information, financially securing, and collecting out-of-pocket responsibility from guarantors to maximize hospital reimbursement.

Essential Job Functions

• Maintain compliance with EMTALA, DNV, HIPAA and all other hospital and government regulations applicable to the Admissions settings and in handling of Medical Records
• Provide excellent customer service at all times by effectively meeting customer needs, understanding who the customers are, and building quality relationships
• Answer telephone in a professional and courteous manner, record messages and communicate to appropriate medical staff
• Provide and obtain signatures on required forms and consents
• Obtain, verify, and enter complete and accurate demographic information on all accounts to facilitate smooth processing through the revenue cycle
• Verify insurance benefits for all plans associated with patient, confirming the correct payor and plan is entered into the patient accounting system
• Obtain insurance authorizations as required by individual insurance plans where applicable
• Maximize the efficiency and accuracy of the collection process by pursuing collections at the time of service in a customer service-oriented fashion
• Scan all registration and clinical documentation into the system and maintain all medical records
• Assist with coordinating the transfer of patients to other hospitals when necessary
• Respond to medical record requests from patients, physicians and hospitals
• Maintain cash drawer according to policies
• Maintain log of all patients, payments received, transfers and hospital admissions
• Maintain visitor/vendor log
• Distribute mail appropriately
• Assist with compiling, analyzing, and reporting data for Patient Access quality measures
• Ensure QA on patient registrations, admissions and transfers
• Ensure QA of site-specific medical records storage and upkeep
• Assist in ordering office supplies, dietary and employee snacks where applicable
• Assist with management of worklists/workqueues within the patient accounting system
• Serve as first line of contact for PAS when on duty
• Assist with training of new employees in all aspects of their assigned job
• Work alongside Patient Access team members to ensure processes and policies are being followed

Other Job Functions

• Maintain a clean working environment for the facility. This includes the front desk, restroom, waiting room, break area and patient rooms when assistance is needed by medical staff
• Receive deliveries including mail from various carriers and forward to appropriate departments as needed
• Notify appropriate contact of any malfunctioning equipment or maintenance needs
• Attend staff meetings or other company sponsored or mandated meetings as required
• Assist medical staff as needed
• Perform additional duties as assigned

Basic Qualifications

• High School Diploma or GED, required
• 3 years patient registration and insurance verification experience in a health care setting, required.
• Emergency Department experience strongly preferred.
• Knowledge of various insurance plans (HMO, PPO, POS, Medicare, Medicaid) and payors, required.
• Basic understanding of medical terminology
• Excellent customer service
• Working knowledge of MS Office (MS Word, Excel and Outlook), strongly preferred.
• Position requires fluency in English; written and oral communication