Patient Access Specialist

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Job description

Love + medicine is who we are, it's what we do, it's why people want to work here. If you're looking for a job to love, apply today.

Scheduled Weekly Hours:

40

Job Description:

POSITION SUMMARY: Responsible for timely processing, documenting, scheduling and follow up of referrals and request for treatment authorizations as requested by the primary provider. The Patient Access Specialist provides superior customer service to both internal and external customers regarding insurance coverage, referral and prior authorization information and patient liability. Responsible for ensuring that all accurate and completed registration, demographic information, and insurance coverage is secured prior to services being rendered, and that all patient liability estimates and expectations are communicated and attempted. Works closely with patients to identify and apply proper financial assistance.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

PROFESSIONAL EXCELLENCE

1. Maintain ongoing tracking and appropriate documentation on referrals.

2. Ensure that referrals are addressed in a timely manner.

3. Assemble information concerning patient's clinical background and referral needs.

4. Works collectively with insurance carriers, patients and internal contacts to identify referrals and/or prior authorization requirements, and assists with securing these requirements before services are provided, resulting in timely reimbursement and final disposition of claims.

5. Responsible to ensure accurate and complete data for promptly registering patients, gathering, verifying and up-dating demographics, as well as insurance and benefit information to drive a timely billing process for our patients.

6. Explains topics of insurance coverage, treatment costs, and financial assistance opportunities to patients and/or family members.

7. Identifies, communicates, and collects outstanding balances according to facility policy and initiates patient contacts.

8. Is involved in all departmental quality and customer service improvement projects.

9. Disputed accounts are researched thoroughly and corrections are made when necessary.

10. Assists with general office tasks.

11. Adheres to facility dress code.

12. Collaborates with other patient care and business related functions to assure that our processes support a positive financial outcome for the facility and for the patient.

PATIENT CENTERED PRIORITES

13. Represents GBAHC's high standards for customer service in all telephone and face to face communication through courteous, patient and respectful conduct and conversation, while meeting the needs of all customers encountered. 14. Identifies and appropriately assist uninsured and under-insured patients with financial assistance.

15. Works closely with clinical departments to ensure that all necessary pre-service information is communicated timely and effectively.

RESPECT AND COMPASSION

16. Supports Gundersen Area Hospitals and Clinics' mission, vision and values. 17. Maintains the security of patient financial information and records 100% of the time.

18. Complies with HIPAA policies and regulations 100% of the time.

19. Promotes a positive work environment; recognizes and acknowledges the efforts and accomplishments of others.

COMMUNICATION

20. Attends 90% of department meetings.

21. Recommends to supervisor the ordering of equipment when necessary.

22. Communicates effectively with patients, employees, supervisor and other facility staff.

SAFETY AND QUALITY

23. Follows safety rules and regulations 100% of the time

24. Protects and respects facility property, equipment and supplies.

25. Participates in facility safety drills and maintains compliance with Infection Control Practices.

IV. ADDITIONAL DUTIES AND RESPONSIBILITIES

1. Performs other duties as directed by the Director of Revenue Cycle.

2. Other duties as may be necessary to fulfill the responsibilities of this position.

3. Fills in where ever needed in order to get the job done.

V. PHYSICAL REQUIREMENTS: USE: NR=NOT REQUIRED O=OCCASIONALLY (1-33%) F=FREQUENTLY (34-66%) C=CONTINUOUSLY (67-100%) STRENGTH % MANUAL DEXTERITY/ MOBILITY/COORDINATION % PUSH/PULL LIGHT OBJECTS O PERFORM SIMPLE MOTOR SKILLS C PUSH/PULL OBJECTS 20 LBS O HAND/EYE COORDINATION/SKILLS (i.e., keyboarding) C PUSH/PULL THAN 20 LBS O ARM/HAND COORDINATION/SKILLS (i.e., calibration of equipment, splint making ) C PUSH/PULL 50 LBS O WALK, STAND F LIFT/CARRY LIGHT OBJECTS O SQUAT, BEND, KNEEL O LIFT/CARRY OBJECTS 20 LBS O REACH ABOVE SHOULDERS O LIFT/CARRY OBJECT 20 LBS O DRIVE O LIFT/CARRY OBJECTS 50 LBS O REMAIN IN UNCOMFORTABLE POSITIONS FOR LONG PERIODS NR LIFT/CARRY OBJECTS 100 LBS NR STAND FOR PROLONGED PERIODS O TRANSFER PATIENTS WITH MINIMAL TO MODERATE ASSISTANCE O SIT FOR PROLONGED PERIODS C CLIMB STAIRS O VISUAL % HEARING / SPEECH % SEE OBJECTS FAR AWAY O HEAR NORMAL SOUND WITH SOME BACKGROUND NOISE C SEE OBJECTS CLOSELY C DISTINGUISH SOUND VIA TAPE TRANSCRIBING, ETC. NR DISCRIMINATE COLORS NR SPEAK CLEARLY C VI. MENTAL REQUIREMENTS: USE: NR=NOT REQUIRED O=OCCASIONALLY (1-33%) F=FREQUENTLY (34-66%) C=CONTINUOUSLY (67-100%) CONCENTRATION / MEMORY % ATTENTION SPAN / CONCEPTUALIZATION % CONCENTRATE ON MINIMAL DETAIL WITH LITTLE INTERRUPTION C ATTEND TO TASK/FUNCTION FOR LESS THAN 10 MINUTES AT A TIME C CONCENTRATE ON MODERATE DETAIL WITH LITTLE INTERRUPTION C ATTEND TO TASK/FUNCTION FOR 10-20 MINUTES AT A TIME C CONCENTRATE ON MODERATE DETAIL WITH SOME INTERRUPTION C ATTEND TO TASK/FUNCTION FOR 20-45 MINUTES AT A TIME. C CONCENTRATE ON MODERATE DETAIL WITH CONSTANT INTERRUPTION C ATTEND TO TASK/FUNCTION FOR MORE THAN 60 MINUTES AT A TIME C CONCENTRATE ON FINE DETAIL WITH LITTLE INTERRUPTION C UNDERSTAND & RELATE TO SPECIFIC IDEAS GENERALLY ONE AT A TIME C CONCENTRATE ON FINE DETAIL WITH SOME INTERRUPTION C UNDERSTAND AND RELATE TO SPECIFIC IDEAS GENERALLY SEVERAL AT A TIME C CONCENTRATE ON FINE DETAIL WITH CONSTANT INTERRUPTION C UNDERSTAND AND RELATE TO CONCEPTS BEHIND SPECIFIC IDEAS C REMEMBER TASK/ASSIGNMENT FOR A FEW HOURS DURING SHIFT C NEEDS TO UNDERSTAND AND RELATE TO THE THEORIES BEHIND SEVERAL RELATED CONCEPTS C REMEMBER TASK/ASSIGNMENT FOR A FULL SHIFT C REMEMBER TASK/ASSIGNMENT GIVEN AT BEGINNING OF A PERIOD OF TIME EXTENDING SEVERAL DAYS C REMEMBER MULTIPLE TASKS/ASSIGNMENTS GIVEN TO SELF AND OTHERS OVER A PERIOD OF SEVERAL DAYS C REMEMBER MULTIPLE TASKS/ASSIGNMENTS GIVEN TO SELF AND OTHERS OVER LONG PERIODS OF TIME C VII. ENVIRONMENTAL CONDITIONS: USE: NR=NOT REQUIRED O=OCCASIONALLY (1-33%) F=FREQUENTLY (34-66%) C=CONTINUOUSLY (67-100%) % % EXPOSURE TO BLOOD, BODY TISSUE OR FLUIDS O EXPOSURE TO DUST O EXPOSURE TO HAZARDOUS WASTE MATERIALS OTHER THAN BLOOD, BODY TISSUE, OR FLUIDS NR EXPOSURE TO OTHER HAZARDOUS MATERIALS SUCH AS CLEANING AGENTS O EXPOSURE TO NORMAL (65°F - 85°F) TEMP. C EXPOSURE TO BODILY INJURIES NR EXPOSURE TO EXTREME COLD ( 32°F) NR EXPOSURE TO UNPLEASANT NOISES O EXPOSURE TO EXTREME HEAT ( 95°F) NR EXPOSURE TO UNPLEASANT ODORS O EXPOSURE TO SUDDEN FLUCTUATIONS IN TEMPERATURES NR EXPOSURE TO ELECTRICAL HAZARDS NR EXPOSURE TO SEASONAL CONDITIONS IN OUTSIDE WEATHER NR EXPOSURE TO ELECTRO-MAGNETIC RADIATION AS IN CRTS (VDTS) NR EXPOSURE TO GREASE OR OIL NR EXPOSURE TO BURNS NR EXPOSURE TO TOXINS, CYTOTOXINS, OR POISONOUS SUBSTANCES NR EXPOSURE TO MECHANICAL HAZARDS NR

WORK RELATIONSHIPS AND SCOPE: Reports directly to Manager, Revenue Cycle. Has contact with patients for, referral and prior authorization information, insurance information, billing and collection purposes.

MEASURES OF PERFORMANACE:

* Quality, accuracy, timeliness, reliability and thoroughness of work performed.
* Ability to gain the trust and respect of the Manager Revenue Cycle, CFO, staff and other employees.
* Ability to communicate effectively and develop good working relationships with others. Soundness of business decisions made.
* Ability to maintain the integrity of highly confidential business information

KNOWLEDGE, SKILLS AND ABILITIES:

* Requires a High School diploma. Technical school certifications in healthcare or business program preferred.
* Previous experience in a healthcare setting helpful.
* Strong oral and written communication skills.
* Knowledge of regulations related to collection activities preferred.
* Must be personable, positively assertive, and display professional competence. Ability to understand and follow hospital policies and procedures.

If you need assistance with any portion of the application or have questions about the position, please contact the recruiter listed below:

Primary Recruiter:

Jenny Dax

Recruiter Email Address:

Equal Opportunity Employer