Patient Access Advocate I - Emergency Department

Presbyterian Healthcare Services • Albuquerque, NM

5d • $16 - $24 • 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 includes updating demographics, verifying insurance, collecting point-of-service liabilities, and documenting registration information in the ADT system to ensure accurate accounts and clean billing. The advocate applies basic knowledge of Medicare (CMS) guidelines and other applicable compliance requirements.

The position provides customer service to patients and families during registration, offers wayfinding assistance to patients and visitors, explains insurance benefits and patient liabilities, and helps ensure accounts are financially cleared at the time of service. It is based at Presbyterian Kaseman Hospital in Albuquerque, New Mexico, and works 12-hour night shifts.

Requirements

• High school diploma or GED.
• At least 6 months of experience in a healthcare setting or 1 year of customer service experience.
• Pass the two-week Patient Access Academy with a score of at least 85% within 6 months of starting.
• Pass the EPIC proficiency test with a score of at least 85% at the completion of Epic training.
• Strong keyboarding skills for efficient data entry and documentation.
• Knowledge of Microsoft Office products.
• Basic understanding of registration and healthcare.
• Basic knowledge of Medicare (CMS) guidelines and applicable Patient Access compliance requirements.

Nice To Haves

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

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 language and de-escalation processes; manage conflict and seek supervisor assistance when needed.
• Implement PROMISE and CARES behaviors in every encounter.
• Educate patients about insurance benefits and liabilities, and communicate patient liabilities transparently.
• Review accounts to ensure they are financially cleared at the time of service and help alleviate patient concerns about hospital financial matters.
• Register patients and collect or confirm demographic, insurance, and other financial information needed to complete accounts.
• Obtain missing insurance details, including policy and group numbers, date of birth, and insurer contact information.
• Verify insurance eligibility and benefits through electronic systems or direct contact with payers.
• 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 requirements, admissions forms, benefit entitlement verification, and billing requirements.
• Complete the Medicare Secondary Payer Questionnaire (MSPQ) at the time of service when needed.
• Meet productivity standards and monitor the Data Quality program, correcting errors at the time of service.
• Maintain appropriate records and timely, accurate documentation in the system of record.
• Collect identified patient financial obligations, including 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 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 legal and compliance requirements.
• Demonstrate CARES behaviors: Collaborate, be Accountable, Respect, Engage, and Serve.
• Provide wayfinding assistance to patients and visitors.

Benefits

• Medical, dental, and vision insurance.
• 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