The Patient Access Specialist has responsibility for accurate and efficient admitting, registering, scheduling, bed placement, and financial analysis activities for all patients upon arrival to the Healthcare System, including initiation of activities necessary to comply with managed care contracts. Review accounts with inadequate financial coverage for the purpose of coordinating and facilitating an application for State Agency or Charity at pre-admission, admission, or in the out-patient/emergency room arena for reimbursement of services rendered. Also responsible for responding expeditiously in a professional and courteous manner to patient information inquiries, greeting and initiating the registration process upon patient?s arrival to the Healthcare System, and directing visitors to appropriate individual or area. The Specialist must maintain and promote an attitude of professionalism as reflected by courteous actions, maintenance of confidentiality and appropriate presentation of self; consistently demonstrate excellent oral and written communication skills; possess the knowledge and skills necessary to provide interactive communications appropriate to the age of the patient being served; interact appropriately with third party payers and other departments; and have the ability to relate well to people of a broad socio-economic mix. Strong organizational skills and a commitment to teamwork are essential. Must have ability to work closely in a clinical setting involving some stressful situations, personal flexibility; moderate sitting, standing, stooping, bending and moderate work at portable computers required. Work closely with clinical areas and physician offices to keep abreast of any new updates or changes with regards to new procedures/test. The Specialist must be willing to work weekends, rotate shifts and holidays to cover departmental needs. Additional activities include review of departmental policies, participation in performance improvement projects and cross-train and function successfully in two areas of the department.
Work requires knowledge of general business principles usually acquired through two years post-secondary education in accounting or in a related healthcare or business field or equivalent combination of education and experience. 35 words per minute typing speed required. Certified Patient Access Representative Certification (CPAR) and Certified Healthcare Access Associate (CHAA) within one year of hire.
BS in Business Administration or other related field
Must have a minimum of one year experience working in a Patient Access role. Must meet PAS Level I requirements. See Job Description A6101. If candidate has previously worked as a PAS I, must have CPAR certification and participated in a minimum of one departmental quality initiative. Work generally requires four years of experience in a health care setting involving customer service to become knowledgeable in practices involved in patient admissions and financial counseling and/or coordination of services related to insurance verification, ancillary scheduling and bed placement or an equivalent combination of relevant education and/or experience. Knowledge of self pay collections, medical terminology, basic ICD9 skills, and/or a complete understanding of insurance is required. Must possess fluent computer skills including functional knowledge of Windows, Word Processing and Excel. Must be proven to possess excellent communication skills and be able to interface appropriately with others of multiple ethnic and educational backgrounds. Highly organized, detail-oriented, self-starter with strong math skills who can function efficiently and professionally with all customers, both internal and external, in a demanding environment. Candidates with prior experience working as PRN for the department with demonstrated knowledge and skills and satisfactory evaluations will be considered for the position.
Position Requirement(s): License/Certification/Registration
CPAR/CHAA within 1 year of hire date.
Department Position Summary:
The Patient Access Specialist has responsibility for:
1. Scheduling ancillary procedures and tests in an accurate, timely and professional manner
2. Acquiring a valid physician order for all scheduled procedures
3. Ensuring that all scheduled procedures requiring prior notification & authorization have been met prior to the patient?s arrival for services
4. Accurate, timely, and efficient pre-registration of all scheduled patients
5. Verifying demographic and insurance information from the patient; obtaining and verifying third party payer information, pertinent diagnosis and/or ICD-9 codes
6. Will have a thorough understanding of medical necessity and APC requirements.
7. Collecting co-pays, deductibles, deposits and payments on accounts
8. Ensuring that self-pay accounts, as well as those with balances after insurance, receive a financial review as needed,
9. Registration of all scheduled, called in admissions, outpatients, Same Day Surgery patients and Emergency patients.
Mission: To improve the health of people we touch.
Vision: To be recognized locally, regionally and nationally as a premier health system.
R.E.S.P.E.C.T.: We will fulfill the mission and vision by adhering to the Standards of R.E.S.P.E.C.T.
Erlanger Health System - 24 months ago