Patient Account Specialist II

DRISCOLL HEALTH PLAN•Corpus Christi, TX

About The Position

This position reports to the department manager and is responsible for creating patient accounts in the EMR patient accounting system to support patient care departments and the revenue, billing, and reporting cycle for reimbursement. Responsibilities include patient accounting functions, referral order record management, patient scheduling, pre-registration/registration, pre-admission, admission, benefit verification, gathering insurance benefit details, obtaining authorizations, creating cost estimates, documenting authorizations and referral orders, obtaining consent signatures, granting MyChart access, documenting actions, and managing patient financial discharge tasks. This role is a key promoter of service excellence, aiming to meet and exceed customer needs.

Requirements

High school diploma or general education degree (GED) required.
3+ years in healthcare access management or billing experience OR 2 years' experience + associate or higher education degree.

Responsibilities

Create patient accounts in the EMR patient accounting system.
Manage referral order records.
Perform patient scheduling.
Handle pre-registration, registration, pre-admission, and admission processes.
Verify patient benefits and gather insurance details.
Procure authorizations as required by payer policy.
Create estimates of cost.
Document authorizations and referral orders.
Obtain consent signatures.
Grant MyChart or MyChart non-patient proxy account access.
Document actions taken and manage patient financial discharge tasks.
Promote service excellence.
Maintain utmost level of confidentiality.
Adhere to hospital policies and procedures.
Demonstrate ethical business practices and integrity.
Adhere to customer service standards and dress code.
Answer department telephone promptly and courteously.
Greet patients and families with courtesy and concern.
Listen to customer needs and take appropriate action.
Work cooperatively with all levels of staffing and care settings.
Process patient accounts according to established workflows.
Process expected ED admissions, direct admissions, and transfers.
Create CCT or HBRT encounters.
Process provider orders for care, searching for referral orders first.
Accurately create patient records and/or encounters in patient accounting systems.
Gather patient demographic and financial information kindly and courteously.
Verify patient insurance benefits and document findings within the appropriate timeframe.
Follow payer requirements for authorization procurement and admission notification.
Schedule patients for necessary procedures and obtain authorizations.
Request and follow cases for required questionnaires and documents.
Complete emergency visit arrival events in a timely manner.
Reschedule patients upon request and notify their physician.
Add notes to each encounter in patient account notes.
Manage appointment waiting lists and canceled lists.
Refer cases for financial screening as necessary.
Add clear copies of picture identification and insurance cards to the patient's EMR.
Explain business forms and obtain signatures.
Issue Patient Rights and Responsibilities and Notice of Privacy Practice.
Issue patient identification cards or wristband identification.
Escort patients/families to the appropriate service area.
Contact the Patient Intake Nurse for all direct admissions.
Manage admissions to various service areas.
Follow discharge workflows.
Manage visitor volume at Welcome desks or admitting office.
Review and manage workqueues to identify potential duplicate referrals, HARs, or medical record numbers.
Review and manage patient accounting work queues for missing registration items.
Review and manage patient demographic and financial data for accuracy.
Review documented notes for payment requirements.
Explain insurance benefits, provide cost estimates, and explain billing workflow.
Prepare hospital receipts for payments received.
Validate and update patient name, address, and phone number.
Ensure all paperwork is complete and insurance cards/identification cards are copied.
Document all actions taken at discharge in the patient accounting system.
Ensure the department's petty cash is always in balance.
Receipt and reconcile all payments received daily per shift.
Follow the department's Standard Operating Procedure for cash handling.