Job Description
• Work Status: Full-time | 40 Hours per week
• Shift Details: Evenings & Weekends Required
• Department: Patient Access
Job Summary
Patient Access Specialist is responsible for scheduling, pre-registrations, and/or authorizations for all PMC patients and conducting pre-admission services. Employee will understand and know how to discuss financial obligations and properly refer patients to others for help. This position is responsible for verifying medical necessity for all tests and procedures, physician follow up relating to medical necessity and insurance eligibility determinations. They are responsible for scheduling various exams for multiple departments via the computer. Specialist coordinates schedules to ensure proper sequencing of exams by departments. The Patient Access Department provides services to supply the foundation for medical records, billing and collections
Essential Functions
• Proficiency with hospital registration and ancillary computer systems. Know how to register the patient, verify their insurance, check eligibility, determine benefits, scan and retrieve documents in the imaging system. Must know how to take payments and print receipts etc.
• Compliance with government regulations as follows:
• Health Insurance Portability and Accountability Act (HIPAA).
• Emergency Medical Treatment and Active Labor Act (EMTALA).
• Consent for Treatment (General Consent).
• Patient Rights and Responsibilities.
• Medicare Important Message.
• Notice of Privacy Practices.
• Medicare Secondary Payer Questionnaire (MSPQ).
• Be able to give excellent customer service to both patients and fellow employees, even in adverse situations. Skills must include empathy and compassion.
• Receives and directs visitors.
• Assists patients.
• Works effectively and with flexibility with other employees in fast-paced environment.
• Start conversations regarding patient financial obligations, financial assistance and payment plans. Works closely with financial counselor and/or patient accounts staff.
• Basic understanding of the Revenue Cycle, including registration, scheduling, referrals, authorizations, benefits and eligibility.
• Answer telephone using proper phone etiquette and relay messages.
• Maintain thorough understanding of various types of payers, and financial class, as well as primary vs. secondary.
• Complete insurance eligibility and benefit verification for all available payers using electronic transactions when available and telephone contacts when required.
• Understand all expected job outcomes and display personal accountability at all times in order to meet all commitments.
• Attention to detail and accuracy and achieve outcomes consistent with the specific job requirements.
• Attends and participates in departmental meetings, in-services, and/or seminars. Attends and participates in 100% mandatory meetings. Completion of Care Learning on yearly basis.
• Performs other related duties as assigned.
Competencies
• Knowledge in Microsoft Excel, Word and internet.
• Knowledge in general office procedures.
Qualifications
• Education:
• High school diploma or equivalent.
• Certified Healthcare Access Associate (CHAA) Certification or equivalent required.
• One year certificate from college or technical school preferred.
• Experience:
• Prior experience in a business office or customer service setting.
• Knowledge of medical terminology preferred.
Why join Providence Medical Center?
• Competitive compensation with shift differential.
• Complete benefits package.
• Collaborative and supportive work environment.
• Opportunities for advancing education, certifications, and training.
Help us shape the future of PMC and contribute to our continued growth!
• Mission: Providing Quality Healthcare in the Spirit of Christ.
• Vision: Being the Hospital and Employer of Choice.
• Values: Honesty, Excellence, Accountability, Respect, Teamwork
Job Tags
Full time, Shift work, Weekend work, Afternoon shift,