Talent.com
Patient Access Specialist I
Patient Access Specialist IDecatur Memorial Hospital • Springfield, IL, US
Patient Access Specialist I

Patient Access Specialist I

Decatur Memorial Hospital • Springfield, IL, US
30+ days ago
Job type
  • Full-time
Job description

Patient Access Specialist

Our Patient Access Specialist assists in providing access to services provided at the hospital and / or other service area. Processes registration information for the patient visit, obtaining patient demographic and third party information with a high degree of accuracy, and performs financial collections. Performs the timely completion, preparation, and deployment of legal, ethical and compliance related documents that must be presented and thoroughly explained to the patient at the time of registration. Maintains knowledge of JCAHO, Patient Rights and Responsibilities, HIPAA, HMOs, Commercial Payers, and departmental / system policies and procedures. Provides Mammography Screening scheduling services to patients. Work may be performed in a patient care area. Serves as a liaison between ancillary departments and other Patient Access Services areas.

Qualifications

Education :

High School diploma required.

Licensure / Certification / Registry :

Must successfully complete assigned annual education through Healthcare Business Insights.

Experience :

One (1) years of business office experience, preferably in the areas of Patient Access, billing, collections, insurance principles / practices, or accounts receivable. Completion of 12 (twelve) hours of coursework in a business or healthcare related field of study may be considered in lieu of business office experience. Previous experience in Patient Access is highly desirable.

Other Knowledge / Skills / Abilities :

  • Knowledge of all tasks performed in the various Patient Access Service areas is necessary to provide optimum internal and external customer satisfaction and provide the opportunity for accurate reimbursement.
  • Demonstrates superior patient relations and interpersonal skills; demonstrates an appropriate level of mental and emotional tolerance and even temperament when dealing with staff, patients and general public, using tact, sensitivity and sound judgment; promotes a positive work environment and contributes to the overall team efforts of the department and organization.
  • Working knowledge of computers is required, with the ability to enter and retrieve data, and electronically notate registration software, and other required applications / systems.
  • Must demonstrate detail orientation, critical thinking, and problem solving ability.
  • Must demonstrate excellent oral and written communication and customer service skills, with ability to maintain a calm and professional demeanor in high stress situations.
  • Demonstrated ability to remain flexible, and consistently exercise sound judgment and initiative in very stressful situations.
  • Ability to effectively manage competing priorities and work independently in a rapidly changing environment.
  • Must demonstrate ability to educate, persuade, and negotiate effectively with patients and families.
  • Knowledge of medical terminology, medical procedural (CPT) and diagnosis (ICD 10 CM) coding, and hospital billing claims preferred, but not required.

Responsibilities

  • Completes all steps of pre-registration / registration; verifies patient identity and demographic information through appropriate tools. Identifies / captures appropriate health insurance benefit eligibility based on contract / regulatory differentiation. Facilitates appropriate billing of claims and hospital reimbursement. Obtains and validates proper consent for patient treatment.
  • Schedules patients for Mammography procedures efficiently, effectively, and according to established protocol for modality, location, facility capabilities, insurance requirements, type of exam, patient preferences, and urgency.
  • Educates patients / others regarding the resolution of billing, private pay options, collection efforts, coordination of benefits, third party and governmental payment criteria, insurance coverage, payments, and denials. May serve as a liaison between external resources and patients on issues requiring SMH involvement.
  • Coordinates with SMH Patient Financial Services, Utilization Management, physicians, and medical offices to ensure consistent financial documentation across the enterprise, and an interdisciplinary approach to patient and organizational needs.
  • Adheres to all CMS Conditions of Participation regulations and Section 1154(e) of the Social Security Act regarding delivery, explanation, and acquisition of patient / designated representative signatures.
  • Verifies medical necessity, and obtains appropriate signature on Advance Beneficiary Notice of non-coverage (ABN) per CMS regulations at points of patient access.
  • Negotiates with patients and families to collect patient co-pays and / or deposits at point of service. Supports Patient Access Services POS (Point of Service) collection goals as defined by Revenue Cycle leadership and best practice benchmarks.
  • Triages, documents, and initiates referrals of patients to Medicaid vendor and / or for financial assistance, per the Illinois Fair Patient Billing Act, Illinois Uninsured Patient Discount Act, and established SMH procedures.
  • Identifies / reviews services requiring pre-authorization / pre-certification by Medicare, Medicaid, Commercial, and Managed Care payers, to ensure provider eligibility requirements are met prior to receiving service. Utilizes appropriate technology and / or communicates with physician offices.
  • Analyzes reports containing rejected accounts from a variety of hospital sources, including Non-Patient Access registration departments, and resolves toward verification of patient benefit eligibility, and subsequent reimbursement from all possible payer sources, or determines suitability for financial assistance.
  • Orients and cross-trains others within assigned area of responsibility as directed and defined by management. May assist other areas within the unit or department, as necessary, during times of special needs or staff absences. May be required to work night or weekend shifts.
  • Ensures compliance with all applicable HIPAA, Joint Commission, CDC, SMH, and state and federal statues, providing required associated literature to patients at all PAS access points. Educates patients regarding Advance Directives, Medicare D prescription coverage, SMH, Joint Commission, and Illinois Department of Public Health grievance process as appropriate.
  • Maintains current knowledge of, and complies with, the Illinois Fair Patient Billing Act and Illinois Uninsured Patient Discount Act at all times.
  • Completes Illinois DHS legal forms for psychiatric admits, in compliance with State of Illinois and SMH statues and guidelines. Provides relevant patient / family education.
  • May rotate work settings, i.e., patient registration, bedside registration, or other SMH campus environments. May be required to provide coverage for the SMH Financial Lobby Office.
  • Develops and maintains a comprehensive knowledge of the health system organization and its functions. Completes all assigned annual organizational education
  • Meets expectations for productivity, accuracy, and point of service collections.
  • Attendance at quarterly department meetings is mandatory unless absence is approved by PAS management prior to the meeting date.
  • Performs pre-registration functions as requested.
  • Performs other related work as required or requested.
  • Create a job alert for this search

    Patient Specialist • Springfield, IL, US

    Related jobs
    Home Health Physical Therapist - $80K-120K per year

    Home Health Physical Therapist - $80K-120K per year

    Graham Healthcare Group • Litchfield, IL, United States
    Full-time
    Graham Healthcare Group is seeking a Home Health Physical Therapist for a job in Litchfield, Illinois.Job Description & Requirements. At Residential Home Health and Hospice (‘Residential’), we’re lo...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse - Post-Anesthesia Care Unit (PACU) RN $1980 / wk

    Travel Nurse - Post-Anesthesia Care Unit (PACU) RN $1980 / wk

    Nomad Health • Cantrall, IL, United States
    Full-time
    Nomad Health seeks an experienced Post-Anesthesia Care Unit (PACU) registered nurse for a travel assignment in IL.Take the next step in your healthcare career and join Nomad Health as a Post-Anesth...Show more
    Last updated: 30+ days ago • Promoted
    General Dentist - Litchfield, IL

    General Dentist - Litchfield, IL

    Litchfield Family Dentistry • Litchfield, IL, USA
    Full-time
    General Dentist - Litchfield, IL at Litchfield Family Dentistry summary : .A General Dentist position in Litchfield, IL, offers a $200K compensation package within a collaborative team at Litchfield ...Show more
    Last updated: 30+ days ago • Promoted
    Patient Access Optimization Analyst

    Patient Access Optimization Analyst

    Baylor Scott & White Health • Springfield, IL, United States
    Full-time
    The Patient Access Optimization Analyst role is to configure and provide functional and technical support for access optimization initiatives. This position also assists with the analysis, solutioni...Show more
    Last updated: 18 days ago • Promoted
    Physician Emergency Medicine - Competitive Salary

    Physician Emergency Medicine - Competitive Salary

    Vituity • Litchfield, IL, US
    Full-time
    Up to $100K Sign On Bonus – Litchfield, IL – Seeking Emergency Medicine Physicians.Join the Physician Partnership Where You Can Increase Your Impact. Vituity’s ownership model prov...Show more
    Last updated: 30+ days ago • Promoted
    Travel Stepdown (PCU / IMC) Telemetry RN - $3,119 per week

    Travel Stepdown (PCU / IMC) Telemetry RN - $3,119 per week

    Access Healthcare • Springfield, IL, United States
    Full-time
    Access Healthcare is seeking a travel nurse RN Intermediate Care for a travel nursing job in Springfield, Illinois.Job Description & Requirements. Access Healthcare Job ID #74026840.Pay package is b...Show more
    Last updated: 1 day ago • Promoted
    Work From Home

    Work From Home

    Remote Jobs • Litchfield, IL
    Remote
    Full-time
    Remote Jobs are now available in your area.This position is a work from home position.You will not need to come into the office. Benefits : Health Insurance, 401K, Vacation& PTO.Apply now! Work f...Show more
    Last updated: 25 days ago • Promoted
    Field Access Manager - Southern Illinois - St Louis MO, Des Moines IA, Springfield IL

    Field Access Manager - Southern Illinois - St Louis MO, Des Moines IA, Springfield IL

    South Dakota Staffing • Springfield, IL, US
    Full-time
    The Field Access Manager (FAM) serves as the subject-matter expert on access related issues for healthcare professionals (HCPs) and healthcare organizations (HCOs), and will work cross-functionally...Show more
    Last updated: 13 hours ago • Promoted • New!
    Restaurant Delivery - Sign Up in Minutes

    Restaurant Delivery - Sign Up in Minutes

    DoorDash • Litchfield, IL, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 26 days ago • Promoted
    Delivery Driver - Sign Up in Minutes

    Delivery Driver - Sign Up in Minutes

    DoorDash • Litchfield, IL, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 26 days ago • Promoted
    Service Center Specialist

    Service Center Specialist

    Sedgwick • Springfield, IL, United States
    Full-time
    By joining Sedgwick, you'll be part of something truly meaningful.It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your c...Show more
    Last updated: 11 days ago • Promoted
    Patient Account Collection Specialist - R-622615_5-7347

    Patient Account Collection Specialist - R-622615_5-7347

    Illinois Staffing • Springfield, IL, US
    Full-time
    Recipient Account Collections Specialist.Cochlear is helping people hear, and be heard, all over the world.Come be a part of our amazing mission and join the number one most trustworthy company in ...Show more
    Last updated: 6 days ago • Promoted
    Optometrist - Litchfield IL

    Optometrist - Litchfield IL

    MRG Exams • Litchfield, IL, US
    Full-time +1
    Join MRG Exams to conduct .Veterans as part of the VA’s SHA process.This is a rewarding non-treating, non-determination role focused solely on assessments.As part of our team, you’...Show more
    Last updated: 27 days ago • Promoted
    Patient Access Specialist - West Wabash Urgent Care

    Patient Access Specialist - West Wabash Urgent Care

    Springfield Clinic • Springfield, IL, US
    Full-time
    Focus on the core content of the job post, removing all extra metadata, navigation mentions, and redundant headers.Keep the job title and job description, ensuring high signal to noise ratio and a ...Show more
    Last updated: 30+ days ago • Promoted
    Physical Therapist PT Home Health

    Physical Therapist PT Home Health

    Elara Caring (BW NHHC Holdco, Inc.) • Litchfield, IL, United States
    Full-time
    At Elara Caring, we have a unique opportunity to play a huge role in the growth of an entire home care industry.Here, each employee has the chance to make a real difference by carrying out our miss...Show more
    Last updated: 30+ days ago • Promoted
    Field Access Manager - Southern Illinois - St Louis MO, Des Moines IA, Springfield IL

    Field Access Manager - Southern Illinois - St Louis MO, Des Moines IA, Springfield IL

    Merck • Springfield, IL, US
    Full-time
    The Field Access Manager (FAM) serves as the subject-matter expert on access related issues for healthcare professionals (HCPs) and healthcare organizations (HCOs), and will work cross-functionally...Show more
    Last updated: 13 hours ago • Promoted • New!
    General Dentist - Litchfield, Illinois

    General Dentist - Litchfield, Illinois

    Litchfield Family Dentistry • Litchfield, IL, US
    Full-time
    General Dentist Opportunity in Litchfield, Illinois - $200,000 total compensation package! .Our commitment to exceptional patient care, cutting-edge technology, and professional growth makes us uni...Show more
    Last updated: 1 day ago • Promoted
    Field Access Manager - Southern Illinois - St Louis MO, Des Moines IA, Springfield IL

    Field Access Manager - Southern Illinois - St Louis MO, Des Moines IA, Springfield IL

    Columbus Staffing • Springfield, IL, US
    Full-time
    The Field Access Manager (FAM) serves as the subject-matter expert on access related issues for healthcare professionals (HCPs) and healthcare organizations (HCOs), and will work cross-functionally...Show more
    Last updated: 13 hours ago • Promoted • New!