Patient Account Specialist I-Admissions

DRISCOLL HEALTH PLAN•Edinburg, TX

About The Position

The Patient Account Specialist I is responsible for creating patient accounts in the EMR patient accounting system to support patient care departments and the revenue, billing, reporting, and reimbursement cycle. Duties include patient accounting, referral order record management, scheduling, pre-registration and registration, pre-admission and admission, insurance benefit verification and documentation, authorization procurement, cost estimates, obtaining consent signatures, MyChart account access, documenting actions, and completing patient financial discharge tasks. The role promotes service excellence and works with patients, families, coworkers, and care teams to meet customer needs and support clean claim processing. The position reports to the department manager. It requires confidentiality, adherence to hospital policies and procedures, ethical conduct, and compliance with customer service standards. Rotating shifts may be required, the role may participate in disaster plan A or B teams, and occasional travel may be required.

Requirements

High school diploma or GED.
One year of related experience and/or training is preferred.

Nice To Haves

One year of related experience and/or training.

Responsibilities

Maintain confidentiality and adhere to hospital policies, procedures, ethical business practices, corporate compliance, integrity guidelines, customer service standards, and dress code.
Answer department telephone calls promptly and greet patients and families courteously; listen to customer needs and take appropriate action.
Work cooperatively with staff across levels and care settings to support care outcomes.
Process patient accounts according to established workflows, coordinating with DAC staff on expected ED admissions, direct admissions, transfers, and CCT or HBRT encounters as indicated.
Process provider orders, search for existing referral orders, and create referral records when needed.
Create accurate patient records and encounters using appropriate search criteria, naming conventions, and interview methods.
Gather patient demographic and financial information courteously.
Verify insurance benefits, document findings within the appropriate timeframe, and follow EMTALA guidelines for ED arrivals and services.
Follow payer requirements for authorization procurement and admission notification.
Schedule necessary procedures and obtain authorizations for planned services as required by insurance carriers.
Request and follow up on required questionnaires and documents, including H&P, PCP referrals, and CPS consents.
Complete emergency visit arrival events promptly.
Reschedule patients upon request and notify the patient's physician.
Add concise, relevant notes to patient account encounters.
Manage appointment waiting and canceled lists to help ensure services are provided promptly.
Refer cases for financial screening as necessary.
Copy picture identification and insurance cards, front and back, into the patient's EMR.
Explain business forms and obtain signatures; issue patient rights and responsibilities and the Notice of Privacy Practice as indicated.
Issue patient identification cards or wristbands as appropriate and ensure patients or families are escorted to the appropriate service area.
Contact the Patient Intake Nurse for direct admissions as indicated; manage admissions to service areas and follow discharge workflows.
Manage visitor volume at welcome desks or in the admitting office as indicated.
Review work queues for potential duplicate referral numbers, HARs, or medical record numbers; address missing registration items and check patient demographic and financial data for accuracy.
Review documented notes for payment requirements, explain quoted insurance benefits and billing workflows, and provide estimates of charges.
Prepare hospital receipts for payments, validate and update patient contact information, ensure paperwork and copied identification and insurance cards are complete, and document discharge actions in the patient accounting system.
Keep departmental petty cash balanced, receipt and reconcile payments daily per shift, and follow cash-handling procedures.