Patient Access Specialist

Under the supervision of the Patient Access Manager; the Patient Access Specialist is responsible for performing the Patient Access function including registration of patients, rating appropriate financial class, obtaining appropriate insurance information and scheduling patient appointments while maintaining department quality standards. Specialist is also responsible for symptom and temperature screenings of hospital visitors.

CHARACTERISTICS DUTIES

• Screens hospital visitors for symptoms and temperature to ensure the health and safety of BMC staff and visitors.

• Assists hospital visitors with questions and directs them to clinic/service location.

• Reviews and update patient accounts to ensure BMC has accurate and current information to process claims and obtain payment.

• Refers all non-funded patients to Financial Counseling Department as appropriate.

• Reviews eligibility to determine required referrals and pre-certifications.

• When appropriate obtains referrals and pre-certifications notifies departments when payer has not approved.

• Identifies potential problems, actively searches for solutions and continually provides input to team regarding ideas and recommendations.

• Informs patient of financial responsibility.

• Collects patient payments under cash collection policy.

• Expands working knowledge of assigned job and various other aspects within the Patient Access Department.

• Initiates pre-registration process and conducts interviews for all patients with a third party payer source; and reviews eligibility to determine required referrals and pre-certifications.

• Documents all information along with treatment authorization into Patient Accounting system. Performs other duties as assigned by supervisor.

PERFORMANCE STANDARDS

• Demonstrates ability to direct visitors according to the Entrance Screening Protocol.

• Accurately screens visitors with appropriate questions and use of thermometer.

• Maintains a minimum of 98% accuracy in the Meditech system.

• Ensures 100% of inpatient admissions are verified for benefits coverage within one day of admission.

• Ensures orders are completed and received before scheduling and registration process occurs 100% of the time.

• Demonstrates strong interpersonal and persuasive abilities in order to establish and maintain a positive relationship with Patient Access staff, patients and patient families, third party payors, government agencies, fiscal intermediaries, utilization review and providers.

MINIMUM QUALIFICATIONS

• One year clerical experience.

• Experience utilizing computers in work environment.

• Working knowledge of Microsoft Office.

• Excellent written and verbal communication skills