Patient Access Specialist

Jamestown Regional Medical Center•Jamestown, ND

13d•Onsite

About The Position

STATEMENT OF PURPOSE The Patient Access Specialist is responsible for verification of all patient accounts in an effort to assist with registration to ensure accuracy to decrease insurance claim denials. They are responsible for verifying the accuracy and completeness of all registrations and assisting in the education of daily activity of the patient access department. This position has a great understanding of the admitting and registration process and is able to work in all areas of admissions. This is a Full time benefited position working 80 hours a pay period. Days of work are Monday - Friday with no nights, weekends or holidays. JOB FUCTIONS Verifies patient insurance information with insurance companies to determine eligibility, type of coverage, and primary payer. Inquires about preauthorization for Cardiac Rehab and assists with Series accounts in emergency room and oncology. Ensures and enters the pre-authorizations for Surgery and Radiology for non JRMC provider services. Reviews all non JRMC accounts and Cardiac Rehab accounts for medical policies prior to service. Assists the department supervisor in working patient access work queues, checking for accuracy and completeness. Verifies all registration or admissions of patient accounts are correctly completed. Works closely with the business office and HIM to validate all patient accounts. Mains communication and promotes cooperation with other departments in regards to patient accounts. When required, will be assigned to work in various admission areas; interviews patients, gathering information including but not limited to demographic data, insurance information and emergency notification, and obtains appropriate signatures. Functions as the telephone switchboard when required. Assists in the scheduling of patient for the clinic and rehab departments. Discusses payment arrangements with patients, receives payments and prepares receipts. Interacts with patients of all age groups (infants, pediatrics, adolescents, adults, and geriatrics) while performing duties. Responds appropriately to emergency situations i.e Code Blue, fire alerts, stat calls, etc. Conducts department in-services as requested by department manager. Works on PC including Microsoft programs (Word, Excel, Outlook) projects. Mains registration proficiency program. Assists supervisor and manager with quality reviews. Performs other related duties as assigned or requested. Will assist with departmental policies and procedures Will become or is a super trainer. Is back up for Financial Counseling. Is the back-up JRMC clinic provider insurance specialist. Assists in maintaining the HPE, Self-Pay and C. Rehab calendars.

Requirements

QUALIFICATIONS/REQUIREMENTS FOR THIS POSITION: (PATIENT ACCESS SPECIALIST)
PREPARATION AND TRAINING - High school level of knowledge preferred. Must be able to follow oral or written orders. Good written and verbal communication skills are needed.
WORK EXPERIENCE - One year clerical experience and insurance background is required.
ATTENDANCE - Punctual and regular attendance is an essential responsibility of each employee at JRMC. Employees are expected to report to work as scheduled, on time and prepared to start working. Employees are also expected to remain at work for their entire work schedule.
ANALYTICAL ABILITY - Analytical ability is required. Good organizational skills are needed.
INDEPENDENT JUDGEMENT - Independent judgment is often required; moderate consequences of errors of judgment.
CONTACTS WITH OTHERS - Social sensitivity and effective communication is required with public contact and co-workers; compliance to behavior standards is required.
SUPERVISING THE WORK OF OTHERS None
RESPONSIBILITY FOR WELFARE OF OTHERS - Infrequently provides for the physical well-being of the patient which may result in serious consequences, i.e. emergency calls such as to call codes.
MENTAL/VISUAL EFFORT - Must be able to concentrate amid distractions; think clearly under pressure; and work regularly requires high level of mental/visual effort. Must be able to speak and write the English language in an understandable manner. Must be in good general health and demonstrate emotional stability. Visual acuity necessary for performing routine procedures.
WORKING CONDITIONS - Works in well-lit office with some inconvenience caused by crowded work area; area subject to temperature discomforts and noise. May be required/requested to work on shifts other than the one for which hired. Participates in and complies with JRMC Safety Management Program. Maintains knowledge of and observes Standard Precautions. Practices aseptic techniques whenever appropriate. OSHA Job Classification: This position is defined as a Category II: Employee does not have exposure to bloodborne pathogens.
PHYSICAL AND SENSORY EFFORT - Must be able to occasionally accomplish movement of computer paper and forms that are a maximum of 50 pounds. Occasional reaching, stooping, bending, kneeling, and crouching. Constant sitting is required to perform the major responsibilities of this job.
PROMOTION - No formal line of promotion.
PHYSICAL REQUIREMENT - These are physical requirements of the position that may be performed as part of daily duties. Inability to meet one or more of these physical requirements will not automatically disqualify a candidate or employee from the position. Upon request for a reasonable accommodation, JRMC may be able to adjust or excuse one or more of these requirements, depending on the requirement, the essential functions to which it relates, and the proposed accommodation.
EMPLOYEE REQUIREMENTS
Visual Observation - Continuously
Standing - Rarely
Walking - Occasionally
Sitting - Continuously
Hands and Finger Dexterity - Frequently
Reaching with Hands and Arms - Frequently
Climbing - Rarely
Stooping/Kneeling/Crouching/Crawling - Rarely
Hearing/Listening - Continuously
Tasting or Smelling - Rarely
Working Inside - Continuously
Working Outside - Rarely
Working in Extreme Heat - Rarely
Working in Extreme Cold - Rarely
Working with Hazardous Materials - Rarely
Noise - Rarely
Working in Dirt/Dust - Rarely
Driving - Never
Lifting / Carrying / Pushing / Pulling: -
Up to 10 pounds - Rarely
Up to 25 pounds - Rarely
Up to 50 pounds - Never
Up to 75 pounds - Never
Up to 100 pounds - Never
Over 100 pounds - Never

Responsibilities

Verifies patient insurance information with insurance companies to determine eligibility, type of coverage, and primary payer.
Inquires about preauthorization for Cardiac Rehab and assists with Series accounts in emergency room and oncology.
Ensures and enters the pre-authorizations for Surgery and Radiology for non JRMC provider services.
Reviews all non JRMC accounts and Cardiac Rehab accounts for medical policies prior to service.
Assists the department supervisor in working patient access work queues, checking for accuracy and completeness.
Verifies all registration or admissions of patient accounts are correctly completed.
Works closely with the business office and HIM to validate all patient accounts.
Maintains communication and promotes cooperation with other departments in regards to patient accounts.
When required, will be assigned to work in various admission areas; interviews patients, gathering information including but not limited to demographic data, insurance information and emergency notification, and obtains appropriate signatures. Functions as the telephone switchboard when required. Assists in the scheduling of patient for the clinic and rehab departments.
Discusses payment arrangements with patients, receives payments and prepares receipts.
Interacts with patients of all age groups (infants, pediatrics, adolescents, adults, and geriatrics) while performing duties.
Responds appropriately to emergency situations i.e Code Blue, fire alerts, stat calls, etc.
Conducts department in-services as requested by department manager.
Works on PC including Microsoft programs (Word, Excel, Outlook) projects.
Maintains registration proficiency program. Assists supervisor and manager with quality reviews.
Performs other related duties as assigned or requested.
Will assist with departmental policies and procedures
Will become or is a super trainer.
Is back up for Financial Counseling.
Is the back-up JRMC clinic provider insurance specialist.
Assists in maintaining the HPE, Self-Pay and C. Rehab calendars.