Position Summary: The Patient Access Specialist is responsible for registering new patients, collecting, and verifying insurance eligibility, patient demographic, financial and other information. Works with patients, Third Party Payers, and the practices to maximize collections.
Pre-Registers new patients by prior to visit; making/receiving patient calls; Collects and accurately documents patient demographic, financial, and other relevant personal information into the EMR system.
Verifies patient identification; copy and store insurance cards and identification cards into the EMR system.
Confirms financial clearance; educate patients on payment options and payment arrangements.
Verifies insurance eligibility and benefits using automated eligibility systems, payer websites and or calls the insurance carriers during pre-registration
Inform patients of their financial responsibilities prior to visits. Coordinates the collection of all estimated patient liabilities, including co-payments and, unmet deductibles and/or any outstanding balances.
Works eligibility exception reports to identify invalid insurance for patients and provide financial counselling as needed.
Updates changes to patient insurance and/or demographic information as needed
Manages referral and authorizations information as assigned through daily work queues and documents activities into the EMR system; may require contacting physicians and/or payors for referrals and authorizations via phone calls and/or websites
Communicates regularly with physicians and other medical providers regarding clinical clarifications for referrals and authorizations, medical necessity requirements, and facilitating conversations with different payers
Documents daily activities in a timely, thorough, and accurate manner into the hospital information system
Completes assigned work queues, projects, and other duties as directed
Required Education and Experience:
High School Diploma/GED required. Bachelors preferred
1-2 years of prior physician office, clinic or hospital registration or billing experience required.
Knowledge of insurance coverage and referral, authorization policies required.
Knowledge of Athena EMR system preferred
Strong understanding of Microsoft Office product suite.
Excellent customer service and communication skills, both written and verbal.
Self-starter with strong team player and leadership abilities.
Strong analytical and problem-solving skills.
Ability to prioritize and meet pre-determined deadlines.
Must be able to effectively multi-task, and have advanced technical skills, as appropriate.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to talk or hear. The person in this position frequently communicates with associates, physicians, and patients and must have the ability to communicate information and ideas so others will understand. Must be able to exchange accurate information in these situations. Strong verbal and written communication skills required. This position requires the ability to observe details at close range (within a few feet of the observer). The person in this position must be able to remain in a stationary position for 50% of the time, standing or sitting. Must be able to position to maintain supply closet and employee files. Constantly operates a computer and other office productivity machinery, such as a desk phone, calculator, copy machine and computer printer. Repetitive motion of upper body required for extended use assisting patients. Ability to exercise good judgment and positively influence others, including handling confrontations with poise and efficiency.
Position Type/Expected Hours of Work:
This is a full-time position in an outpatient medical business office setting. Based on business need, the ability to work a flexible schedule, including some overtime as approved in advance.
This position may require travel to other White-Wilson locations.
This position requires regular and reliable on-site attendance. Environmentally controlled medical environment. Fast paced environment with occasional high pressure or emergent situations.
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
White-Wilson Medical Center, P.A. and affiliates are equal opportunity employers, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.