Patient Access Specialist - Avalon Health Park - Monday & Tuesday 6:45am - 5:15pm, Thursday & Friday 8:30am -7:00pm

Wellstar Health System

1d • Onsite

About The Position

Avalon Health Park has an opportunity for a Patient Access Specialist. This role is typically the first point of contact and must ensure a pleasant experience for patients and visitors. The specialist interviews patients and/or their representatives to obtain complete and accurate demographic, financial, and insurance information required for billing and collecting patient accounts. They conduct intensive screening of all Medicare, Medicaid, and managed care patients for pre-certification requirements and provider service eligibility prior to registration. The role also obtains all necessary customer consents/attestations, coordinates the collection of all estimated patient liabilities, and verifies insurance benefits and coverage for inpatients and outpatients. Responsibilities include responding to customer requests, analyzing and rectifying concerns, using the computer to access and update customer records, verifying and posting transactions, and following established procedures for processing receipts and cash. The specialist also assists with general hospital information and directions, establishes financial arrangements to reduce financial risk for the hospital, and acts as a role model in guest relations, demonstrating a positive attitude and actively participating in Quality Improvement processes.

Requirements

• High School Diploma General or GED General or Associates
• CHAA - Cert Healthcare Access Assoc or CPAR - Certified Patient Account Rep or CRCR - Certified Revenue Cycle Rep or CRCR-P - Certified Revenue Cycle Rep - Provisional (90 Days) within 120 Days
• Minimum 1 year experience in healthcare, or institutional work setting.
• Computer/data entry experience.
• Ability to communicate with various members of the healthcare team.
• Effective communication skills (both written and verbal), attention to detail, self-directed and a positive attitude are essential.
• Effective problem solving and critical thinking skills.
• Patient Access Services (PAS) Operations Onboarding Training followed by a minimum passing score of on final exam within 45 days of hire.

Nice To Haves

• Working knowledge of patient registration systems and intermediate Microsoft Office Suite are preferred.
• Epic experience preferred.

Responsibilities

• Receives requests for reservations (patient scheduling) from physicians offices and makes the necessary pre-admission arrangements, referring to lists of dates allotted for scheduling, and advising physicians office staff of unavailable dates.
• Interviews each patient or representatives to obtain complete and accurate demographic, financial and insurance information.
• Enters all patient information into the registration system.
• Obtains all necessary signatures and is knowledgeable regarding any special forms that may be required by the patients third-party payer.
• Reads physicians orders to determine the procedures requested and to instruct patients accordingly.
• Escorts or arranges to have patient escorted to procedure areas and assigned rooms.
• Makes corrections and updates patient account information in computer.
• Obtains new medical record numbers for newborn admissions and other new patients.
• Documents thorough explanatory notes on patient accounts, concerning any non-routine circumstances, clarifying special billing processes.
• Maintains a working knowledge of available information system capabilities and performs all system applications that are required.
• Understands and applies WHS philosophy and objectives, and PAS policies and procedures, as related to assigned duties.
• Understands the admission, outpatient and emergency registration process.
• Maintains confidentiality of patient information, in accordance with WHS policy and HIPPA regulations.
• Consistently demonstrates the ability to organize work, recognizes and establishes appropriate work priorities, and completes work in a productive manner, without creating backlogs.
• Maintains proficiency in data entry skills.
• Assists physicians and their office staff to expedite scheduling, pre-admission, Medicaid screening and pre-certifications on all accounts.
• Resolves errors and applicable Claim, DNB and Patient Work Queues.
• Greets all guest with a positive and professional attitude.
• Receives patients valuables for safekeeping in the hospital safe.
• Answers incoming phone calls and follows through with requests made.
• Maintains courteous and cooperative working relationships with WHS management, patients, physicians, other professional contacts, and the general public.
• Demonstrates ability to tactfully handle difficult situations.
• Presents a well-groomed and professional image in coordination with dept/ hospital dress codes.
• Attempts to collect the estimated self-pay balance of all inpatient, outpatient and ER accounts, at the earliest possible collection control point.
• Monitors in-house accounts and attempts to make financial arrangements with guarantors for payment of their self-pay balances in full and prior to discharge.
• Completes financial evaluation forms to document guarantors' income, expenses, assets and liabilities.
• Identifies those patients without adequate insurance coverage.
• Makes personal contact with patient or guarantor to determine guarantor's ability to pay non-covered charges, as well as to determine potential eligibility for financial assistance programs (namely Medicaid).
• Maintains a list of health care financial assistance programs and the eligibility requirements for each program.
• Refers patients/guarantors to sources of outside funding assistance, as needed.
• Works efficiently and accurately within designated time frames to ensure a continuity of information and cash flow.
• Contacts scheduled patients at home to obtain pre-admission information, explain financial policies, estimate self-pay balances, and obtain a promise to pay on or before admission/registration.
• Interviews all inpatients and select (self-pay) outpatients at time of registration, or at least within 24 hours of admission, to verify complete insurance and financial information, explain financial policies, and collect the estimated self-pay balance.
• Documents concise and understandable notes regarding all self-pay account collection activity, as well as each patient or guarantor interaction.
• Documents all efforts to collect patient account balances, other self-pay collection activities and referrals to Medicaid.
• Coordinates financial counseling activities with Admitting, Outpatient Registration, Emergency Registration, Utilization Review, Nursing, Social Services, and Patient Financial Services.
• Verifies insurance coverage and benefits.
• Exceeds monthly quota on a consistent basis.
• Formally reports results of self-pay collection activity to direct supervisor, on a daily basis or according to policy.
• Provides feedback to PAS management concerning self-pay collection and data integrity issues.
• Responsible for completion of appropriate error/issues in WorkQueues.
• Identifies and resolves Payor Denials as indicated.
• Observes work hours and provides proper notice of absences, tardies work schedule changes.
• Attends select departmental meetings at the request of WHS Management.
• Completes monthly, quarterly, and annual mandatory training as required.
• Performs other duties as assigned.
• Maintains a based on individual QA audit /or as reported by Epic (min. of 10 accounts) registration accuracy rate or higher in the past 12 months.
• Maintains minimum productivity requirements.
• Willing and able to function as a preceptor in the orientation of new patient access personnel and students.
• Maintains required certifications by obtaining necessary CEUs and submitting timely to certifying board.
• Complies with all WellStar Health System policies, standards of work, and code of conduct.

Benefits

• Nationally ranked and locally recognized for our high-quality care and inclusive culture, Wellstar is one of Georgia’s largest and most integrated healthcare systems.
• Join us and discover the support to do more meaningful work—and enjoy a more rewarding life.
• Connect with the most integrated health system in Georgia, and start a future that gives you more.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree