Admissions Specialist I

Texas Health Resources•Bedford, TX

6d•Onsite

About The Position

As a compassionate member of the care team, the Admissions Specialist I will welcome patients and their families upon arrival, putting them at ease and setting a positive tone for their visit. This role involves accurately gathering complete demographic information to ensure electronic health record integrity, identifying correct network coverage, and validating healthcare benefits and/or pre-certification for applicable tests and procedures to maximize reimbursement. The specialist will also educate patients and families on legal, ethical, and compliance documents, ensure regulatory consents are signed, and prepare estimates for financial obligations, collecting co-payments and deposits. Key responsibilities include completing essential payor and government required elements such as the MSPQ, Important Message from Medicare (IMM), and medical necessity checking (ABN and Letter of Non-Coverage). The role requires staying up-to-date with and complying with all applicable regulations, operating systems, entity, and system policies and procedures, while maintaining customer service and productivity guidelines. The Admissions Specialist I is expected to be an engaged and willing partner, mentoring peers, exhibiting flexibility, and adapting easily to change. They will participate in staff meetings, process improvement initiatives, special projects, and complete other assigned duties, while maintaining daily Epic work queue and personal Employee Scorecard Dashboard. A crucial aspect of the role is maintaining awareness and accuracy of THR contracted insurance plans and communicating potential financial implications, such as out-of-network coverage, to patients and families.

Requirements

High School Diploma or Equivalent is required.
1 Year Relevant Customer Service experience required.
CPI - Crisis Prevention Intervention Training maintained annually 90 days required.
Ability to promptly assess requests by using electronic and paper resource materials and correctly respond to patient inquiries.
Excellent data entry, numeric, typing and computer navigational skills, with attention to details.
Proficient computer skills, medical terminology, Epic, Microsoft Office, and assorted software programs.
Exhibits a pleasant, professional, polished presence exhibiting the ability to troubleshoot utilizing critical thinking skills.
Requires exceptional listening, interpersonal and communication skills, and professional, pleasant, and respectful telephone etiquette.
Ability to maintain a professional demeanor in a highly stressful and emotional environment, to include crime, behavioral health and suffering patients in addition to life-or-death situations.
Must be able to exhibit a high level of empathy with the ability to effectively communicate with patients and family members during life changing events, while demonstrating exceptional customer service skills.
Demonstrates ability to manage multiple, changing priorities in an effective and organized manner and appropriately escalating concerns to leadership.

Nice To Haves

2 Years Professional office/healthcare experience preferred.
CHAA - Certified Healthcare Access Associate Upon Hire preferred.

Responsibilities

Welcome patients and their families upon arrival, putting them at ease and setting the tone for the rest of the visit.
Accurately gather complete demographic information to ensure electronic health record integrity consistent with high reliability organization principles.
Identify correct network coverage and obtain and/or validate healthcare benefits and/or pre-certification for applicable tests and/or procedures to maximize reimbursement for services rendered.
Educate patients and/or families about applicable legal, ethical, and compliance documents; ensure regulatory consents are signed by the appropriate parties.
Engage with patients in understanding their financial obligations based on the financial policy and accurately prepare estimates to collect co-payments, self-pay deposits, and patient balances.
Ensure all payor and government required elements are completed correctly, particularly the MSPQ, Important Message from Medicare (IMM) and medical necessity checking (ABN and Letter of Non-Coverage).
Stay up to date and comply with all applicable regulations with the operating systems, entity and system policies and procedures.
Maintain customer service and/or productivity guidelines set forth by applicable leadership.
Mentor peers, exhibit flexibility, and adapt easily to change.
Participate in staff meetings, process improvement, special projects and complete other duties as assigned.
Maintain daily Epic work queue and personal Employee Scorecard Dashboard.
Maintain awareness and accuracy of THR contracted insurance plans; as well the ability to communicate with patients/and families alerting patients of Out of Network and advise of potential financial implications, such as non-coverage.