Patient Access Specialist I - ED Services

Wellstar Health System•LaGrange, GA

About The Position

The Patient Access Specialist I is typically the first point of contact for patients presenting to the Emergency Department and is responsible for providing a pleasant, professional patient and visitor experience. The specialist follows EMTALA protocols before registering emergency patients; verifies identity and demographic information; screens Medicare, Medicaid, and managed-care patients for network status and coordination of benefits; obtains required consents and attestations; and verifies insurance coverage and benefits. The role handles patient registration, account updates, signatures, medical record numbers, documentation, and required system applications. It also responds to questions and requests, provides hospital information and directions, collects and posts patient payments, and follows receipt-handling procedures. The specialist supports financial counseling and self-pay collections, helps identify financial assistance options, and coordinates with relevant hospital departments. The position requires compliance with confidentiality, hospital policies, attendance and training requirements, and service standards.

Requirements

High school diploma required.
At least 1 year of experience in healthcare or an institutional (corporate) work setting required.
Computer and data-entry experience required.
Ability to communicate with various members of the healthcare team.
Effective written and verbal communication skills, attention to detail, self-direction, and a positive attitude.
Effective problem-solving and critical-thinking skills.
Associate’s degree preferred.
Epic experience preferred.
Working knowledge of patient registration systems and intermediate Microsoft Office Suite skills preferred.

Nice To Haves

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

Responsibilities

Interview patients or representatives to obtain complete and accurate demographic, financial, and insurance information.
Enter patient information into the registration system and correct or update patient account records.
Obtain required signatures and special forms, and follow EMTALA protocols before registering emergency patients.
Review physicians’ orders, determine requested procedures, and instruct patients accordingly.
Escort patients or arrange for them to be escorted to assigned rooms.
Obtain new medical record numbers for newborn admissions and other new patients.
Document explanatory notes on accounts, including non-routine circumstances and special billing processes.
Maintain knowledge of information-system capabilities and complete required system applications.
Maintain patient confidentiality in accordance with WHS policy and HIPAA regulations.
Organize work, prioritize appropriately, complete work productively, maintain data-entry proficiency, and resolve errors in applicable Claim, DNB, and Patient WorkQueues.
Greet guests professionally, answer incoming calls, and follow through on requests.
Receive patient valuables for safekeeping in the hospital safe.
Maintain courteous and cooperative relationships with management, patients, physicians, professional contacts, and the public; tactfully handle difficult situations.
Maintain a well-groomed and professional image consistent with department and hospital dress codes.
Attempt to collect estimated self-pay balances for inpatient, outpatient, and emergency accounts at the earliest appropriate collection point.
Complete financial evaluation forms documenting guarantors’ income, expenses, assets, and liabilities.
Identify patients without adequate insurance and contact patients or guarantors to assess ability to pay and potential eligibility for financial assistance, including Medicaid.
Maintain information about financial assistance programs and eligibility requirements, and refer patients or guarantors to outside funding sources as needed.
Work efficiently and accurately within designated time frames to support continuity of information and cash flow.
Document self-pay collection activity, patient or guarantor interactions, collection efforts, and Medicaid referrals.
Coordinate financial counseling activities with the PAS Financial Counselor, Registration, Utilization Review, Nursing, Social Services, and Patient Financial Services.
Verify insurance coverage and benefits.
Exceed monthly collection quotas consistently and report self-pay collection results to the direct supervisor as required.
Provide PAS management feedback concerning self-pay collections and data integrity issues.
Complete appropriate WorkQueue errors and issues and identify and resolve payor denials as indicated.
Observe work hours and provide appropriate notice of absences, tardiness, and schedule changes.
Attend selected departmental meetings at management’s request and complete required monthly, quarterly, and annual training.
Comply with WellStar Health System policies, standards of work, and code of conduct.
Perform other duties as assigned.