Patient Access Specialist 1 WMCG

Wellstar Health System

1d•Onsite

About The Position

This job serves as the first point of contact for patients and visitors, ensuring a pleasant experience. Responsibilities include interviewing patients to gather complete and accurate demographic, financial, and insurance information for billing and account collection. The specialist conducts intensive screening for pre-certification and provider service eligibility, obtains necessary consents, and coordinates the collection of estimated patient liabilities like co-payments and deductibles. They also verify insurance benefits, respond to customer requests, and resolve concerns using established procedures. The role involves using computer systems to access and update records, processing receipts, and assisting with hospital information and directions. A key aspect is establishing financial arrangements to mitigate risk for Wellstar Health System (WHS) and ensure reimbursement for services. Wellstar's mission is to enhance the health and well-being of every person, delivering world-class healthcare with compassion, excellence, and by honoring every voice. As one of Georgia's largest and most integrated healthcare systems with over 24,000 team members, Wellstar is recognized for high-quality care and an inclusive culture, having been featured on FORTUNE’s “100 Best Companies to Work For” list.

Requirements

High School Diploma or GED
Minimum 1 year in healthcare, or institutional (corporate) work setting
Computer/data entry experience
Ability to communicate with various members of the healthcare team
Effective communication skills (both written and verbal)
Attention to detail
Self-directed
Positive attitude
Effective problem solving and critical thinking skills
PAS Operations Onboarding Training followed by a minimum passing score on final exam within 45 days of hire

Nice To Haves

Associate's General degree
Working knowledge of patient registration systems
Intermediate Microsoft Office Suite skills
Epic experience

Responsibilities

Receives requests for reservations (patient scheduling) from physicians offices and makes the necessary pre-admission arrangements, referring to lists of dates allotted for scheduling, and advising physicians office staff of unavailable dates.
Interviews each patient or representatives to obtain complete and accurate demographic, financial and insurance information.
Enters all patient information into the registration system.
Obtains all necessary signatures and is knowledgeable regarding any special forms that may be required by the patients third party payer.
Reads physicians orders to determine the procedures requested and to instruct patients accordingly.
Escorts or arranges to have patient escorted to procedure areas and assigned rooms.
Makes corrections and updates patient account information in computer.
Obtains new medical record numbers for newborn admissions and other new patients.
Documents thorough explanatory notes on patient accounts, concerning any non-routine circumstances, clarifying special billing processes.
Maintains a working knowledge of available information system capabilities and performs all system applications that are required.
Understands and applies WHS philosophy and objectives, and PAS policies and procedures, as related to assigned duties.
Understands the admission, outpatient and emergency registration process.
Maintains confidentiality of patient information, in accordance with WHS policy and HIPPA regulations.
Consistently demonstrates the ability to organize work, recognizes and establishes appropriate work priorities, and completes work in a productive manner, without creating backlogs.
Maintains proficiency in data entry skills.
Assists physicians and their office staff to expedite scheduling, pre-admission, Medicaid screening and pre-certifications on all accounts.
Resolves error and applicable Claim, DNB, and Patient Work Queues.
Greets all guest with a positive and professional attitude.
Receives patients valuables for safekeeping in the hospital safe.
Answers incoming phone calls and follows through with requests made.
Maintains courteous and cooperative working relationships with WHS management, patients, physicians, other professional contacts, and the general public.
Demonstrates ability to tactfully handle difficult situations.
Presents a well-groomed and professional image in coordination with dept/ hospital dress codes.
Attempts to collect the estimated self-pay balance of all inpatient, outpatient and ER accounts, at the earliest possible collection control point.
Monitors in-house accounts and attempts to make financial arrangements with guarantors for payment of their self-pay balances in full, prior to discharge, or within ten working days thereafter.
Completes financial evaluation forms to document guarantors' income, expenses, assets and liabilities.
Identifies those patients without adequate insurance coverage.
Makes personal contact with patient or guarantor to determine guarantor's ability to pay non-covered charges, as well as to determine potential eligibility for financial assistance programs (namely Medicaid).
Maintains a list of health care financial assistance programs and the eligibility requirements for each program.
Refers patients/guarantors to sources of outside funding assistance, as needed.
Works efficiently and accurately within designated time frames to ensure a continuity of information and cash flow.
Contacts scheduled patients at home to obtain pre-admission information, explain financial policies, estimate self-pay balances, and obtain a promise to pay on or before admission/registration.
Interviews all inpatients and select (self-pay) outpatients at time of registration, or at least within 24 hours of admission, to verify complete insurance and financial information, explain financial policies, and collect the estimated self-pay balance.
Documents concise and understandable notes regarding all self-pay account collection activity, as well as each patient or guarantor interaction.
Documents all efforts to collect patient account balances, other self-pay collection activities and referrals to Medicaid.
Coordinates financial counseling activities with Admitting, Outpatient Registration, Emergency Registration, Utilization Review, Nursing, Social Services, and Patient Financial Services.
Verifies insurance coverage and benefits.
Exceeds monthly quota on a consistent basis.
Formally reports results of self-pay collection activity to direct supervisor, on a daily basis or according to policy.
Provides feedback to PAS management concerning self-pay collection and data integrity issues.
Responsible for completion of appropriate error/issues in Work Queues.
Identifies and resolves Payor Denials as indicated.
Observes work hours and provides proper notice of absences, tardies work schedule changes.
Attends select departmental meetings at the request of WHS Management.
Completes monthly, quarterly, and annual mandatory training as required.
Performs other duties as assigned.