Patient Access Account Specialist I-ABQ

Presbyterian Healthcare Services

3d • Onsite

About The Position

Build your Career. Make a Difference. Presbyterian is hiring a skilled Patient Access Account Specialist I. The Patient Access Account Specialist I provides basic functions to financial clear patient accounts for government and commercial accounts prior to the date of service. Performs basic financial clearance functions, including insurance verification, authorization, collection and documentation of patient demographics, benefit analysis, and pre-service collections. The Patient Access Account Specialist I will ensure follow up on authorizations for scheduled and Urgent/Emergent procedures and admissions until date of service or discharge for admissions. The Patient Access Account Specialist I must possess a basic knowledge of Medicare (CMS) guidelines, as well as other Compliance Regulatory guidelines applicable to Patient Access to include HIPAA, EMTALA, and CMS guidelines of MSPQ. The Patient Access Account Specialist (PAAS I) monitors work queues for financial clearance and missing authorizations ensuring a payment source is identified and secured and there is a clean claim for billing.

Requirements

• High school diploma, continued education preferred
• Pass Patient Academy with passing score of 85% or higher
• Previous completion and passing of Patient Access Advocate II and III Advancement test.
• A minimum of 2 years of work experiences in healthcare setting within Patient Access and/or billing plus strong customer service background.
• Strong knowledge and understanding of insurance and financial processing of accounts.
• Proficient in EPIC ADT system

Nice To Haves

• CHAA, CHAM or other industry equivalent certification preferred
• Pass annual competency exam for all areas of responsibility.

Responsibilities

• Ensures accounts are financially cleared prior to date of service to alleviate patient concerns over hospital financial matters
• Performs the patient registration process.
• Manage the accurate collection of patient data which includes but is not limited to; Obtain/confirm and enter demographic and other financial and clinical information necessary for final clearance of scheduled accounts.
• Review Urgent/Emergent admission accounts for notification, financial clearance and authorization pre-discharge.
• Obtain missing insurance information, to include policy number, group number, date of birth, and insurance phone number if not already identified in account.
• Verify insurance for eligibility and benefits using online electronic verification system or by contacting payer directly.
• Collects identified patient financial obligation amounts including residual balance if applicable.
• Collect liability from patient prior to visit or make arrangements for payment at time of service.
• Ensure a payer source has been identified prior to services being rendered.
• Ensure authorization for correct procedure (CPT), facility, and date of service is obtained.

Benefits

• medical
• dental
• vision
• short-term and long-term disability
• group term life insurance
• other optional voluntary benefits
• Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees