Patient Access Specialist II

Fairview Health Services•Edina, MN

About The Position

As part of Revenue Cycle Management, the Patient Access Specialist II creates a positive first impression of M Health Fairview and helps ensure an exceptional experience while interacting with patients, families, and internal and external stakeholders. The role gathers patient demographic and insurance information, verifies eligibility and benefits, communicates financial obligations, and collects payments in a highly organized and professional manner. Staff are expected to demonstrate the M Health Fairview commitments of Integrity, Service, Compassion, Innovation, and Dignity, along with critical thinking, a strong work ethic, and flexibility. The position is scheduled from 5:00 p.m. to 1:30 a.m. at 0.8 FTE, or 64 hours per two-week pay period. Week one is Tuesday, Wednesday, and Thursday; week two is Monday, Tuesday, Friday, Saturday, and Sunday. All staff participate in an on-call rotation, including a weekend on-call rotation. The role 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 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 available resources to code insurance and verify eligibility through online, web-based, or phone systems.
Complete patient check-in, including collecting copayments, obtaining signatures, scanning insurance cards and/or identification, and providing required regulatory notices.
Educate patients about price transparency and estimated financial responsibilities, collect payments, and refer patients to financial assistance or counseling resources when 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, efficiently, and promptly.
Assist in training and mentoring new and existing staff.
Confirm insurance benefits, including coverage limitations, referral or authorization requirements, and patient liabilities.
Prepare proactive price estimates, communicate patient financial responsibilities, collect payments, explain coverage gaps and available options, and refer patients to financial counseling when appropriate.
Prepare and communicate or deliver notices of non-coverage, such as HINN, ABN, waivers, and Medicare lifetime reserve days.
Follow up with payers on active authorized referral requests to verify determinations or the payer's progress in the determination process.
Collaborate with other departments and teams to manage tasks according to established criteria 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 processes that enable collection of expected payment.
Participate in improvement efforts and initiatives supporting organizational goals and vision, and adhere to Revenue Cycle's Escalation Policy.
Rotate between hospital emergency room and scheduled services for registered patients.
Participate in the weekend on-call rotation.