Patient Access Specialist - Access

St. Tammany Parish Hospital•Covington, LA

23h•Onsite

About The Position

The Patient Access Specialist is responsible for completing efficient and organized processes in the areas of registration, check-in/check-out, admission, insurance initiation and verification and benefit research for inpatients/outpatients and scheduling of appointments. Excellent customer service skills are crucial in these roles as well as flexibility in work shifts. The Patient Access Specialist must ensure that accurate information is collected, that they are always sensitive to the confidentiality of this information, and that patients are aware of their rights as determined by HIPAA regulations and company policy, and that they are a consistent proponent of patient throughput and volume growth. The Patient Access Specialist responsibilities include duties such as verifying insurance coverage, benefits, obtaining and initiating authorizations, completing registration pathways in the HIS systems, receiving, maintaining, clarifying, entering and/or validating physician orders, scheduling appointments, determining third party payer liability for organizational billing, checking medical necessity, handling daily batching and posting of point of service payments and having conversations with patients to resolve previous and current balances. Maintains a positive relationship with healthcare team and is a resource to physicians, staff and patients for information regarding orders, insurance and referrals, as well as any other issues that might impact the relationship/experience of these stakeholders. The Specialist is also responsible for training and mentoring other Patient Access Representatives and Specialists in the more technical aspects of job.

Requirements

High school diploma or equivalent.
At least 1 year of previous customer service experience in an office / medical office environment including scheduling, admitting, and/or financial counseling.

Nice To Haves

Some college preferred.
Excellent written and verbal communication skills demonstrating the ability to communicate effectively and courteously with physician office staff, patients, and/or insurance carriers.
Ability to work in a fast-paced professional environment.
Demonstrated competency to successfully perform Patient Access Representative duties, which would typically be obtained through 12 months direct experience.
Ability to understand and solve complex problems dealing with governmental entitlement programs, commercial insurance requirements, contractual obligations, and reporting requirements.
Ability to apply the use and terminology associated with CPT and ICD-10 coding, as well as basic anatomy/physiology, and out-patient diagnostic testing medical terminology, Medicare guidelines, HMO and PPO contracts and other insurance billing processes.
Excellent organizational skills and maintains a professional and neat work environment.
Education or certifications in the following areas are helpful in acquiring a position in the area - as well as for advancement opportunities: Certified Healthcare Access Associate (CHAA) through the National Association of Healthcare Access Management (NAHAM).
Completion of a medical terminology course.
Bilingual - preferably Spanish.

Responsibilities

Completing efficient and organized processes in registration, check-in/check-out, admission, insurance initiation and verification, and benefit research for inpatients/outpatients.
Scheduling appointments.
Verifying insurance coverage and benefits.
Obtaining and initiating authorizations.
Completing registration pathways in HIS systems.
Receiving, maintaining, clarifying, entering, and/or validating physician orders.
Determining third party payer liability for organizational billing.
Checking medical necessity.
Handling daily batching and posting of point of service payments.
Resolving previous and current patient balances through conversations with patients.
Maintaining a positive relationship with the healthcare team.
Serving as a resource to physicians, staff, and patients for information regarding orders, insurance, and referrals.
Training and mentoring other Patient Access Representatives and Specialists in technical aspects of the job.