The Patient Access Associate I exhibits a high level of customer service while verifying and preparing all patient accounts for inpatient and outpatient billing in order to maximize payment for Hospital and Clinic services from all sources. Reviews and verifies all payment methods available (insurance, self-pay, agency), verifies patient/insurance information, works with patients to set up payment arrangements and to arrange/apply for assistance programs, assists in collecting copayments and deductibles, and problem solves basic billing inquiries.
OBTAINS/CONFIRMS AND ENTERS/UPDATES DEMOGRAPHIC AND INSURANCE INFORMATION FOR ALL PATIENTS
Consistently confirms, enters, and/or updates al required demographic data on patient and guarantor on registration system.
Secures and/or explains copies of insurance card(s), forms of ID, and signature(s) on all required forms
Consistently completes the Medicare Secondary Payer (MSP) questionnaire, if applicable.
Verifies insurance to determine coordination of benefits and obtains authorization and/or referrals as required.
Accurately updates the emergency department room tracking system, if applicable.
Follows procedures when identifying a patient and applying the patient identification bracelet, if applicable.
Registers patients during downtime following downtime procedures and enters data into registration system immediately upon system availability.
VERIFIES INSURANCE COVERAGE, SCREENS PATIENT FOR POTENTIAL FUNDING SOURCES, AND SETS EXPECTATIONS FOR REIMBURSEMENT OF SERVICES.
Verifies financial information to determine insurance coordination of benefits, pre-certification/prior-authorization requirements by contacting the insurance company or through other verifying technology
Informs self-pay patients of prepayment requirements or screens for funding sources
Prepares estimate of procedures, calculates advance payment requirements, informs patient of acceptable payment arrangements on previous and current balances
Refers potentially eligible patients to contract eligibility vendor(s) to pursue funding reimbursement
Maintains departmental and/or individual reports as required
Coordinates with clinical areas to establish patient financial expectations and assist in the resolution of revenue cycle issues
ASSURES ACCURATE AND TIMELY RESPONSE TO PATIENT FINANCIAL INQUIRIES RELATED TO THEIR CARE AT SCOTT & WHITE
Provides an escalation pathway for account issues which cannot be resolved
Explains/answers patient billing inquiries and interprets data to resolve accounts
Explains alternative medical financing; assists in completion of applications and contracts in order to meet patient needs while assuring maximum reimbursement to Scott & White
Plans, organizes, and accomplishes tasks according to priority to effectively meet departmental and patient needs
COLLECTS, POSTS, AND RECONCILES ALL PAYMENTS FROM PATIENTS
Consistently collects patient payments and provides receipt accurately completing all required fields
Accurately posts all payments on system
Accurately reconciles receipts with cash collected and completes required balancing forms
CONSISTENTLY DOCUMENTS PATIENT ACCOUNT APPROPRIATELY FOR RECONCILIATION PURPOSES
Documents patient account notes for all interactions/transactions
Images all documents as defined by leadership
PERFORMS OTHER POSITION APPROPRIATE DUTIES AS REQUIRED IN A COMPETENT, PROFESSIONAL, AND COURTEOUS MANNER
KNOWLEDGE, SKILLS, AND ABILITIES
Computer proficient. Excellent verbal communication skills. Ability to handle difficult situations and customers.
Previous office, medical practice, hospital registration, or customer service experience
Ability to determine patients' primary, secondary, and tertiary payer sources. Knowledge of all major governmental and non-governmental payer sources
Experience: 1+ Years
Degree: H. S. Graduate/GED Equivalent
Department: Admitting Office
Standard Hours Per Week: 1