Patient Access Specialist

WVU Medicine

9d•Onsite

About The Position

The Patient Access Specialist greets and receives patients into the health care facility and serves as the first impression of WVU Healthcare. The role is responsible for accurately and promptly processing patient demographic and insurance information, supporting hospital departments through the scheduling system, obtaining electronic signatures for consent to treat and patient financial obligations, and providing excellent customer service through strong written and verbal communication. The position handles patient registration and billing information, required paperwork, payments, scheduling, insurance and coverage screenings, and related account follow-up. It maintains patient confidentiality and compliance with HIPAA, privacy practices, patient rights, and applicable hospital, state, federal, and insurance requirements. The department operates 24/7, and staff participate in a rotating holiday schedule. The position is scheduled for 40 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 downtime procedures.
Knowledge of procedures for reporting or documenting unsafe or hazardous conditions, incidents, and defective equipment in accordance with hospital policy.
Ability to perform repetitive duties throughout the shift.
Attention to detail, organizational ability, and ability to perform multiple tasks simultaneously.
Ability to memorize information and reference written sources or appropriate personnel when needed.
Ability to understand medical insurance payment requirements and basic knowledge of covered services.
Ability to work with people with varied personalities, education levels, capabilities, and communication skills.
Ability to use 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 maintain concentration in a busy office environment.
Ability to work in a confined office space under fluorescent lighting and around noise from office machinery.
Ability to work in a high-volume, fast-paced environment and interact continually with patients and medical and support staff.
Ability to work in an environment with exposure to communicable disease.
Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping, and feeling are required.
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.
Ability to move throughout the work and clinic areas and sit or stand for extended periods.
Reading and comprehension ability.
Department operates 24/7, and staff participate 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 demographic, billing, and insurance information from patients or their representatives; enter it into registration and billing systems; and scan insurance cards and photo identification.
Complete managed care pre-certification and authorization responsibilities as needed.
Prepare registration and privacy paperwork and obtain required signatures, including electronic signatures for consent to treat and financial obligations.
Collect applicable deposits, co-payments, deductibles, and patient liability payments; provide receipts and document payments.
Refer 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 identified by system flags, including courtesy dismissals, comments, and red stickers.
Conduct applicable auto accident liability screening and document pertinent coverage information.
Identify patients with end stage renal disease, obtain pertinent SSI coverage information, and document it in registration and billing systems as needed.
Screen VA-eligible patients and coordinate admission or treatment with the Veterans Administration as needed.
Screen patients covered under Black Lung and document pertinent information as needed.
Screen work-related injury cases, assist with required paperwork, and document information as needed.
Initiate Medicare Secondary Payer Questionnaires, obtain required information, and document it in the registration and billing system.
Maintain confidentiality under policy and HIPAA when communicating demographic, clinical, or 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 calls professionally and courteously and use the phone system correctly.
Schedule, reschedule, or cancel patients according to hospital workflows.
Check order completeness and validate orders against scheduled services.
Communicate with and support hospital departments using the scheduling system.
Follow hospital, state, and federal safety guidelines and ensure compliance with applicable hospital, governmental, and insurance regulations.
Comply with privacy practices and patient rights and responsibilities, and cooperate with the WVUH Corporate Compliance Program.
Interact professionally and with concern for the needs of patients, families, visitors, physicians, staff, and the public.
Participate in service assessment and improvement processes and report results to appropriate administrative levels.