Patient Access Specialist

WVU Medicine

1d•Onsite

About The Position

Greets and receives patients at the health care facility and accurately and promptly processes patient demographic and insurance information. Supports hospital departments through the scheduling system, obtains electronic signatures for consent to treat and financial obligations, and provides customer service as the first point of impression for WVU Healthcare. The role handles registration, billing, scheduling, payments, insurance-related screenings, patient communications, and compliance with privacy and safety requirements. The department operates 24/7, and staff participate in a rotating holiday schedule. The position is scheduled for 36 hours per week with varied shifts.

Requirements

High school diploma or equivalent.
Ability to accurately use applicable computer software and equipment for access processing and follow computer downtime procedures.
Knowledge of procedures for reporting or documenting unsafe conditions, incidents, and defective equipment in accordance with hospital policy.
Ability to perform repetitive duties throughout a shift.
Strong attention to detail, organizational ability, and ability to multitask.
Ability to memorize substantial information and consult written sources or appropriate personnel for information not retained.
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.
Tact and diplomacy when dealing 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 to maintain concentration around office machinery noise.
Ability to work in a confined office space under fluorescent lighting in a high-volume, fast-paced environment, with exposure to communicable disease and continual interaction with patients and medical and support staff.
Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping, and feeling are required; must be able to sit or stand for extended periods and move throughout the work and clinic areas.
Visual acuity within normal range; reading and comprehension ability; and manual dexterity to operate keyboards, fax machines, telephones, and other business equipment.
Must be able to exert more than 50 pounds of force occasionally, up to 25 pounds frequently, and up to 10 pounds constantly to move objects.
Participates in a rotating holiday schedule; the department operates 24/7.

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 point-of-service collection procedures.

Responsibilities

Collects patient, family, or legal guardian demographic, billing, and insurance information; enters it into registration and billing systems and scans insurance cards and photo identification.
May obtain managed-care pre-certifications and authorizations.
Prepares registration paperwork, including consent and privacy forms, and obtains required signatures, including electronic signatures for treatment consent and patient financial obligations.
Collects applicable deposits, copayments, deductibles, and patient-liability payments; provides receipts and records payments in registration and billing systems.
Directs patients who need financial assistance to a Financial Counselor.
Prepares patient identification armbands.
Balances daily receipts and the cash drawer for patient payments as needed.
Follows up on accounts indicated by system flags.
May initiate and document auto-accident liability coverage screening.
May identify end-stage renal disease patients, obtain coverage information, and document screening results.
May screen VA-eligible patients, coordinate admission or treatment with the VA, and document information.
May screen patients for Black Lung SSI coverage and document information.
May screen patients for Workers' Compensation, help complete paperwork, and document information.
Initiates Medicare Secondary Payer Questionnaire screening, gathers required information, and documents it in the registration and billing system.
Maintains confidentiality in accordance with policy and HIPAA when handling demographic, clinical, and financial information.
Provides patients with information about insurance, bill payment, and hospital procedures, and maintains current knowledge of major payer payment provisions.
Performs medical-necessity checks and completes an Advanced Beneficiary Notice as needed.
Answers telephone calls professionally and courteously and uses the phone system correctly.
Schedules, reschedules, or cancels patients in accordance with hospital workflows.
Checks orders for completeness and validates orders against scheduled services.
Communicates with and supports hospital departments using the scheduling system.
Follows hospital, state, and federal safety guidelines and ensures compliance with hospital, governmental, and insurance regulations.
Complies with privacy notices and patient rights and responsibilities and cooperates with the WVUH Corporate Compliance Program.
Interacts professionally and with concern for the needs of patients, families, visitors, physicians, staff, and the public.
Participates in service assessment and improvement and regulatory-compliance processes, and reports results to appropriate administrative levels.