Patient Access Specialist-SMC Gastroenterology

Spartanburg Regional Healthcare System • Spartanburg, SC

2d

About The Position

The Patient Access Specialist receives, coordinates, and implements the initial patient experience. The role performs functions essential to proper clinical treatment, billing and reimbursement, patient satisfaction, and the efficient, accurate completion of patient registration. The position supports specified departments and modalities that may have sensitive clinical or financial needs and complex processes, and helps maintain accurate demographic and financial information for clinical and billing functions.

Requirements

• High school diploma or equivalency.
• At least three years of experience in healthcare access and/or customer service.
• Experience emphasizing financial analysis of insurance benefits for upfront collections.
• Focused knowledge of CPT, HCPCS, and ICD-10 codes.
• Excellent understanding of insurance and medical terminology.
• Solid Microsoft Office skills, particularly Excel and Word.

Nice To Haves

• Associate or bachelor's degree in a business- or healthcare-related field.
• At least four years of experience in healthcare access or customer service.
• At least one year of experience in a financial environment.
• Certified Healthcare Access Associate (CHAA) or Certified Medical Insurance Specialist (CMIS).

Responsibilities

• Assist with onboarding new associates.
• Cross-train current associates.
• Complete comprehensive pre-registration for specified departments and modalities with sensitive patient clinical or financial needs and complex processes.
• Accurately complete quality registrations in the HIS system, maintaining the integrity of demographic and financial information needed for clinical and billing functions for each patient encounter.
• Follow state and federal regulations and system policies concerning compliance, integrity, and ethical registration practices.
• Review medical orders to ensure they comply with government and hospital guidelines and clinical protocols.
• Complete clinical screening for specified modalities to support patient safety.
• Obtain insurance eligibility and benefit information from payors by phone, RTE, or web to provide patients with estimated responsibility for requested or rendered services.
• Review patient and claim edits for accuracy and compliance with government and commercial carriers to support clean claim submission.
• Liaise with the Centralized Referral Center or assigned entity to ensure prior authorizations are obtained, secure payment, and prevent denials.
• Complete or process patient payments for accurate account posting.
• Maintain an accurate cash drawer and perform cash drawer reconciliation and deposit functions.
• Practice AIDET during all customer and patient encounters.
• Perform other duties assigned by the department supervisor or manager.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED