Patient Access Specialist - Business Services, PRN, Varies
North Mississippi Medical Center Tupelo, MS Full-time Administration / Clerical
Posted on March 26, 2022
Registration & Discharge:
Patient Account/Data Entry:
- 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.
- 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.
- 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