Patient Access Specialist

INTEGRIS Health•OK, OK

8d•Onsite

About The Position

The Patient Access Specialist provides patient access services for assigned ancillary, diagnostic, surgical, and emergency services to support efficient operations, timely reimbursement, and patient and employee satisfaction. The role serves as a liaison between INTEGRIS Health and patients, providers, and payers on pre-care matters related to account resolution. The specialist explains coverage eligibility and benefits, patient financial liability, and INTEGRIS Health billing practices and policies, helping patients understand coverage and related terminology. This position is based at INTEGRIS Health Edmond Hospital in Edmond, Oklahoma, and is scheduled Monday through Wednesday, 7:00 a.m. to 7:00 p.m.

Requirements

One year of patient access operations experience, such as scheduling, registration, or insurance, or related experience in billing, collections, or accounts receivable.
Previous experience in scheduling, registration, insurance, billing, collections, or customer service in a hospital or physician’s office setting.
Successful completion of a related Career Tech program of 1,100 or more hours or one year of college coursework in a related field may be considered in lieu of experience.

Nice To Haves

College coursework in a related field or a healthcare certification such as AAHAM CRCS, HFMA CRCR, or NAHAM CHAA.
Previous experience with medical terminology and basic ICD-10 and CPT coding.

Responsibilities

Ensure appropriate handling of complex patient access transactions, including coverage eligibility, insurance verification, patient portion calculations, and authorization requirements, using available systems and resources according to assigned protocols.
Provide financial counseling, including screening for government programs and financial assistance, explaining payment options and arrangements, processing point-of-service payments, verifying patient demographics, obtaining required signatures, imaging documents, and following documentation standards.
Use analytical thinking, independent judgment, and clinical knowledge to adjust service-area schedules and accommodate special requests from internal and external customers.
Answer inbound calls from patients, physician offices, and insurance carriers with the goal of resolving concerns immediately.
Collect patient payments and follow levels of authority to ensure financial clearance.
Concisely document patient account activities, including authorization and patient liability requirements.
Respond promptly to patient inquiries 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.
Understand payer regulations and communicate coverage benefits and financial liability effectively to patients.
Interpret and comply with performance standards, federal and state regulations including EMTALA and HIPAA, policies, procedures, guidelines, and third-party contracts.
Follow workplace safety rules, report accidents promptly, and correct minor safety hazards.