Patient Access Specialist - Business Services, PRN, Varies

North Mississippi Medical Center   Tupelo, MS   Full-time     Administration / Clerical
Posted on March 26, 2022
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Registration & Discharge:
  • Serves as registration access point resource for all patient-facing interactions regarding admission and discharge processes.
  • Initiates pre-registration process and guides patient through critical steps of verification, managed care resolutions, payment transparencies and ultimately financial clearance.
  • Verifies patient identity upon arrival, then initiates activation of record to be accessed through multiple clinical systems.
  • Obtains crucial confidential patient identification information including patient records, signatures and payment information repeatedly and ensures HIPAA guidelines are enforced when such information is obtained.
  • Responsible for verification of insurance coverage for medical necessity screenings.
  • Held accountable for processing unscheduled patients and managing patient schedules across all departments.
  • Effectively communicates NMHS' organizational revenue cycle and financial policies including estimates, charity plans and payment options to patients and patient representatives.
  • Coordinates strategy for patient flow, denial prevention, and cash collections
  • Provides financial counselling to patients and/or patient representatives to manage balances owed
  • Identifies trends and reports issues which are significant and recurring along with possible solutions to the Director of Patient Access
  • Obtains consent forms, insurance and other pertinent confidential patient information to ensure accurate medical record data entry to be reviewed by Joint Commission and CMS
  • Holds primary obligation to other departments to enter information timely to ensure efficient patient procedural flow & proper access of patient account in EMR by other departments in order to correctly identify patient, apply armbands, provide consent form and privacy acknowledgement for clinical chart
  • Processes edits including Case Management task list (maintaining correct status of patient ie, inpatient, observation, etc.)

Patient Account/Data Entry:
  • Apply codes in the patient accounting system when appropriate to ensure an accurate financial record
  • Provides input and help design action plans in conjunction with leadership to identify and resolve payer and patient information related denials.
  • Provide comprehensive data such as emergency contacts, email addresses for Patient Portal, correct data for state and government reporting.
  • Enters accommodation code for Room charges or hourly charges are based on the accommodation code entered by Access staff.
  • Daily maintenance of data edits to correct or add data which include clinical data, financial data, patient survey data, medical record data, etc.

Billing:
  • Familiarity with payer eligibilities and ability to communicate that information to various NMHS staff
  • Ensure optimization of revenue and cash flow through collection of accurate, concise payer and patient information
  • Responsible for daily cash collections, deposits and reconciliation as assigned.
  • Works collaboratively with Health Care Foundation to assist patients in obtaining and funding COBRA coverage.
  • Recognizes patient eligibility for Medicaid and charity coverage processes and initiate appropriate application.
  • Work collaboratively with third party payors to resolve billing issues and impact timely and appropriate payment
  • Professionally and effectively communicates with third party carriers, vendors, patients, and hospital contacts to promote revenue cycle efficiency
  • Contacts insurance companies and patients regarding eligibility and payments
  • Serves as liaison between patients and insurance companies to resolve eligibility issues-Serves as liaison between third party payors and patients to effectively communicate financial clearance information.
  • Takes corrective action through systematic and procedural development to reduce or eliminate payment issues and delays.
Job Knowledge
  • High school diploma or equivalent required.
  • 1 year experience in related field required.
  • Ability to research, analyze, and communicate eligibility trends to identify opportunities and training issues; required
  • Must complete appropriate PAS training curriculum within timeframe defined by Revenue Cycle Leadership annually.
  • Excellent analytical and problem-solving skills; required
  • Must possess strong organizational and interpersonal skills.
  • Experience in Microsoft Office, Outlook, Third Party Payer websites; preferred
  • Ability to adapt to everchanging and unpredictable work environment; required