Patient Access Specialist II

Fairview Health Services•Edina, MN

About The Position

As part of Revenue Cycle Management, this position is responsible for creating a positive first impression of M Health Fairview and ensuring an exceptional experience while interacting with patients, families, and internal and external stakeholders. The role gathers patient demographic and insurance information for complete and accurate registration, identifies insurance, gathers benefit information, communicates financial obligations, and collects payments. The specialist is expected to demonstrate M Health Fairview’s commitments—Integrity, Service, Compassion, Innovation, and Dignity—along with critical thinking, a strong work ethic, and flexibility. The schedule is 4:00 PM to 12:30 AM. Week one is Wednesday and Thursday; week two is Monday, Friday, Saturday, and Sunday. Staff participate in a rotating on-call schedule. The specialist rotates between the hospital emergency room and scheduled services for registered patients.

Requirements

At least 2 years of combined customer service, healthcare revenue cycle, or equivalent Level 1 position experience.
Patient collections experience in a medical setting.
Effective written and verbal communication skills.
Attention to detail, self-direction, and a positive attitude.
Ability to work independently and in a team environment.

Nice To Haves

Post-secondary education.
Ability to perform accurately and efficiently in EPIC, Microsoft Office Suite, and other computer programs.
Experience serving as a subject matter expert and demonstrated willingness to support team questions.

Responsibilities

Interview patients to obtain and document accurate demographic and insurance information in the medical record.
Use insurance knowledge and resources to code insurance and verify eligibility through online, web-based, or phone systems.
Complete patient check-in, including collecting co-pays and signatures, scanning insurance cards and/or IDs, and providing required notices.
Educate patients about price transparency and estimated financial responsibilities, collect payments, and refer patients to financial assistance or counseling resources as appropriate.
Interact with patients and families in challenging situations, using de-escalation skills when needed.
Manage daily worklists and/or work queues and resolve assigned tasks accurately and efficiently; assist in training and mentoring staff.
Confirm insurance benefits, coverage limitations, referral or authorization requirements, and patient liabilities.
Provide proactive price estimates, explain financial responsibilities and coverage gaps, collect payments, and refer patients to financial counseling as appropriate.
Prepare and communicate or deliver notices of non-coverage, such as HINN, ABN, waivers, and Medicare lifetime reserve day notices.
Follow up with payers on active authorized referral requests to verify determinations or the status of the determination process.
Collaborate with other departments and teams to manage tasks in a high-volume environment and provide patients with resources and contacts as needed.
Follow compliance and regulatory requirements, department protocols, and procedures; protect patient privacy and access information only as needed for job duties.
Contribute to collecting expected payments and participate in improvement efforts and initiatives that support organizational goals and vision.
Understand and adhere to Revenue Cycle’s Escalation Policy.
Rotate between the hospital emergency room and scheduled services for registered patients.
Participate in the weekend on-call rotation.