Patient Access Advocate I - Emergency Department-CDS

Presbyterian System Services • Albuquerque, NM

8d • Onsite

About The Position

The Patient Access Advocate I provides primary registration of patient accounts for self-pay, government, and commercial accounts on the date of service for scheduled and unscheduled visits. The role performs registration functions, including updating demographics, verifying insurance, collecting point-of-service liabilities, and documenting registration information in the ADT system. The advocate confirms that accounts contain accurate information to support clean billing and maintains basic knowledge of Medicare (CMS) and other applicable compliance and regulatory guidelines. The role also provides patients and families with high-quality customer service and offers wayfinding assistance to patients and visitors.

This full-time position is based at Presbyterian Hospital in Albuquerque, New Mexico, and works 12-hour night shifts. The position is non-exempt. Candidates must pass the two-week Patient Access Academy with a score of at least 85% within six months of starting and pass the Epic proficiency test with a score of at least 85% at the completion of Epic training.

Requirements

• High school diploma or GED.
• Six months of experience in a healthcare setting or one year of customer service experience.
• Pass the two-week Patient Access Academy with a score of at least 85% within six months of starting.
• Pass the Epic proficiency test with a score of at least 85% at the completion of the Epic training class.
• Be at least 18 years of age at the time of hire.
• Demonstrated strong keyboarding skills for efficient data entry and documentation.
• Basic understanding of registration and healthcare.

Nice To Haves

• CHAA, CHAM, or other industry-equivalent certification.
• Basic understanding of insurance.
• Basic understanding of medical terminology and billing codes, including DRG, ICD-10, CPT, and HCPCS.
• Knowledge of Microsoft Office products.

Responsibilities

• Provide an exceptional patient and family experience using CARES, AIDET, and EPE tools.
• Address and attempt to resolve complaints in the moment using appropriate communication and de-escalation processes; manage conflict and request supervisor assistance when needed.
• Demonstrate PROMISE and CARES behaviors in every encounter.
• Educate patients about insurance benefits and liabilities and communicate patient financial obligations transparently.
• Review accounts and ensure they are financially cleared at the time of service.
• Perform patient registration and collect or confirm demographic and financial information needed to complete accounts.
• Obtain missing insurance information, including policy and group numbers, date of birth, and insurer phone number.
• Verify insurance eligibility and benefits through an electronic verification system or by contacting the payer.
• Document actions accurately in the system of record to support follow-up and maintain an audit trail.
• Maintain knowledge of authorization requirements, payer guidelines, Medicare guidelines, admissions forms, benefit entitlement verification, and billing requirements.
• Complete the Medicare Secondary Payer Questionnaire (MSPQ) at the time of service when it was not completed during financial clearance.
• Meet productivity standards and monitor and track the Data Quality program to ensure errors are corrected at the time of service.
• Maintain appropriate records, files, and timely, accurate documentation in the system of record.
• Collect patient financial obligations, including applicable residual balances, at the time of service.
• Educate patients about available financial assistance, charity, or other programs and refer them to an on-site Financial Advocate or the Financial Advocacy Center when appropriate.
• Complete missing account information to ensure accuracy at the time of the visit.
• Cooperate in risk management activities and investigations; promptly report suspected or potential violations and cooperate with related investigations.
• Conduct transactions in accordance with company policies, procedures, standards, practices, and applicable compliance and legal requirements.
• Perform other duties as assigned.

Benefits

• Medical, dental, and vision coverage.
• Short-term and long-term disability insurance.
• Group term life insurance and other optional voluntary benefits.
• Employee Wellness rewards program, with opportunities to earn gift cards through wellness activities.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED