Patient Access Specialist Sr

INTEGRIS Health•Yukon, OK

17h•Onsite

About The Position

The Patient Access Specialist Sr. provides patient access services for assigned ancillary, diagnostic, surgical, and emergency services to support efficient operations, timely reimbursement, and customer and employee satisfaction. The role serves as a liaison between INTEGRIS and patients, providers, and payers on pre-care matters related to account resolution, and explains coverage eligibility and benefits, patient financial liability, and INTEGRIS Health billing practices and policies. The position handles complex registration and patient access transactions, including scheduling, demographic verification, point-of-service payments, consent paperwork, document imaging, coverage and insurance verification, patient portion calculations, and authorization requirements. It responds to patient and payer inquiries, resolves account concerns, documents account activity, and collects payments. The senior specialist also serves as a resource and systems expert for other patient access specialists, providing guidance, training, feedback, and productivity monitoring. The role coordinates team-oriented process and quality improvement initiatives, tracks progress, and prepares data for presentation. It maintains compliance with performance standards, federal and state regulations including EMTALA and HIPAA, organizational policies and procedures, guidelines, and third-party contracts.

Requirements

Four years of Patient Access operations activities (scheduling, registration, or insurance) or related experience such as billing, collections, or accounts receivable.
Previous experience in scheduling, registration, insurance, billing, collections, or customer service in a hospital or physician's office setting.

Nice To Haves

Bachelor's degree in a related field or a healthcare certification such as AAHAM CRCS, HFMA CRCR, or NAHAM CHAA.
Previous experience with Microsoft Office programs and admission/discharge/transfer or billing/claims management software.
Previous experience with medical terminology, basic ICD-10 and CPT coding, healthcare program reimbursement, and methodologies.
Previous experience in three or more of the following in a hospital or physician's office setting: scheduling, registration, insurance (including Medicare, Medicaid, and third-party regulations), billing, collections, and customer service.

Responsibilities

Ensure complex registration activities are appropriate, including scheduling, verifying patient demographic information, processing point-of-service payments, obtaining signatures for consent paperwork, imaging documents, and following documentation standards.
Ensure complex patient access transactions are appropriate, including coverage eligibility, insurance verification, patient portion calculations, and authorization requirements, using available systems and resources.
Use analytical thinking, independent judgment, and clinical knowledge to adjust service area schedules and accommodate special requests from internal and external customers.
Accept inbound calls from patients, physician offices, insurance carriers, and others, seeking to resolve concerns promptly.
Collect patient payments and follow levels of authority to ensure financial clearance.
Document patient account activities concisely, including authorization and patient liability requirements.
Perform filing, data entry, and other assigned duties.
Respond promptly to patient questions about pre-care services, policies, coverage, benefits, and financial liability.
Use multiple resources to resolve patient or payer inquiries while on the phone or while preparing or reviewing patient accounts or prior authorization requirements.
Explain payer regulations, coverage benefits, and financial liability to patients.
Act as a liaison to resolve complex patient access and account issues, answer reimbursement questions, and serve as a resource and systems expert for patient access specialists.
Provide on-the-job training, guidance, and feedback to staff on processes, payers, and systems; monitor assignments and assess productivity.
Communicate effectively by telephone, email, and verbally with departments and caregivers throughout the health system.
Initiate and coordinate team-oriented process improvement initiatives for the department and organization.
Coordinate continuous quality improvement efforts, establish goals with supervisors, track progress, and prepare data for presentation.
Interpret and maintain compliance with performance standards, EMTALA, HIPAA, federal and state regulations, policies, procedures, guidelines, and third-party contracts.