Patient Access Specialist

WVU Medicine

1d•Onsite

About The Position

The Patient Access Specialist greets and receives patients at the healthcare facility and serves as the first impression of WVU Healthcare. The role processes patient demographic and insurance information accurately and promptly, supports hospital departments through the scheduling system, and obtains electronic signatures for consent to treatment and patient financial obligations. It requires excellent customer service and strong written and verbal communication skills. The specialist gathers, enters, and verifies registration, billing, insurance, scheduling, and coverage information; prepares and obtains signatures on consent and registration documents; collects and records patient payments; and directs patients to financial counseling when needed. The role may also perform authorization, medical necessity, and special coverage screenings, schedule or change appointments, and support hospital departments. The position requires maintaining confidentiality and compliance with applicable hospital, governmental, insurance, privacy, and patient-rights requirements. The department operates 24/7. Staff participate in a rotating holiday schedule. The position is scheduled for 36 hours per week and is non-exempt. The work takes place in a high-volume, fast-paced healthcare setting involving frequent interruptions, a confined office area, fluorescent lighting, office machinery noise, and exposure to communicable disease. It involves continual interaction with patients, medical staff, support staff, and the public, and requires frequent movement and the ability to sit or stand for extended periods.

Requirements

High school diploma or equivalent.
Ability to accurately use applicable computer software and equipment for access processing.
Ability to follow established computer downtime procedures.
Knowledge of procedures for reporting or documenting unsafe and hazardous conditions, incidents, and defective equipment.
Ability to perform repetitive duties throughout a shift.
Attention to detail, organization, and ability to handle multiple tasks simultaneously.
Ability to memorize and retrieve information or reference written sources and appropriate personnel.
Ability to understand medical insurance payment requirements and basic covered services.
Ability to work with people with varied personalities, education levels, capabilities, and communication skills.
Ability to use tact and diplomacy with physicians, patients, and families.
Excellent written and verbal communication skills.
Ability to understand written and oral communication.
Ability to perform assigned tasks despite frequent interruptions and maintain concentration in a high-volume, fast-paced environment.
Physical ability to frequently walk, stand, stoop, kneel, reach, push, pull, lift, grasp, and feel; move throughout the work and clinic areas; and sit or stand for extended periods.
Visual acuity within the normal range.
Ability to exert more than 50 pounds of force occasionally, up to 25 pounds frequently, and up to 10 pounds constantly to move objects.
Manual dexterity to operate keyboards, fax machines, telephones, and other business equipment.
Reading and comprehension ability.
Ability to work within a confined office space, under fluorescent lighting, and amid noise from office machinery.
Ability to work with exposure to communicable disease.
Participation in a rotating holiday schedule.

Nice To Haves

Associate degree in a related medical field, such as medical assisting or medical office administration.
Experience in a medical office setting.
Basic knowledge of medical terminology.
Basic knowledge of third-party payers.
General knowledge of time-of-service collection procedures.

Responsibilities

Obtain patient demographic, billing, and insurance information from the patient, family, or legal guardian; enter it into registration and billing systems; and scan insurance cards and photo identification.
May obtain pre-certifications and authorizations for managed care.
Prepare registration paperwork, including consent forms and privacy notices, and obtain required signatures, including electronic signatures for consent to treatment and financial obligations.
Collect applicable deposits, co-payments, deductibles, and patient liability payments; provide receipts and document payments in registration and billing systems.
Direct patients who need financial assistance to a Financial Counselor.
Prepare patient identification armbands.
Balance daily receipts and the cash drawer for patient payments as needed.
Follow up on accounts as indicated by system flags.
May initiate auto accident liability screening and document relevant medical or no-fault liability information.
May identify patients with end-stage renal disease and document information regarding SSI coverage.
May screen VA eligibility, coordinate admission or treatment with the VA, and document the information.
May screen for Black Lung SSI coverage and document relevant information.
May screen workers’ compensation cases, assist with required paperwork, and document information.
Initiate Medicare Secondary Payer Questionnaires and document required information.
Maintain confidentiality in accordance with policy and HIPAA when handling demographic, clinical, and financial information.
Provide patients with information about insurance, bill payment, and hospital procedures, and maintain current knowledge of major payer payment provisions.
Perform medical necessity checks and complete Advanced Beneficiary Notices as needed.
Answer phone calls professionally and courteously and use the phone system correctly.
Schedule, reschedule, or cancel patients according to hospital workflows.
Check orders for completeness and validate them against scheduled services.
Communicate with and support hospital departments using the scheduling system.
Follow hospital, state, and federal guidelines for a safe environment and ensure compliance with applicable hospital, governmental, and insurance regulations.
Comply with privacy notices and patient rights and responsibilities, and cooperate with the WVUH Corporate Compliance Program.
Interact professionally and considerately with patients, families, visitors, physicians, staff, and the public.
Participate in assessing and improving services and regulatory compliance, and report results to appropriate administrative levels.
Report and/or document unsafe or hazardous conditions, incidents, and defective equipment in accordance with hospital policy.
Follow established computer downtime procedures.