Patient Access Account Specialist I

Location Address:

9521 San Mateo NE Albuquerque, NM 87113-2237

Compensation Pay Range:

Minimum Offer $16.38 Maximum Offer $25.57 Now Hiring: Patient Access Account Specialist I

Summary:

The Patient Access Account Specialist plays an important role in creating a positive patient experience by ensuring accurate and efficient registration, scheduling, insurance verification, and financial processing. This position serves as a key point of contact for patients and families while supporting the administrative and financial processes necessary for timely access to healthcare services.

Type of Opportunity: Full time Job Exempt: No Job is based: Reverend Hugh Cooper Administrative Center Work Shift: Weekday Schedule Monday-Friday (United States of America)

Responsibilities

• Addresses and attempts to appropriately resolve complaints in the moment by using key words at key times and de-escalation processes.
• Ability to manage conflict and appropriately request the help of a supervisor when needed.
• Educates patients for whom they speak regarding insurance benefits and liabilities.
• Ensures accounts are financially cleared prior to date of service to alleviate patient concerns over hospital financial matters
• Performs the patient registration process. Manage the accurate collection of patient data which includes but is not limited to;
• Obtain/confirm and enter demographic and other financial and clinical information necessary for final clearance of scheduled accounts.
• Review Urgent/Emergent admission accounts for notification, financial clearance and authorization pre-discharge.
• Obtain missing insurance information, to include policy number, group number, date of birth, and insurance phone number if not already identified in account.
• Verify insurance for eligibility and benefits using online electronic verification system or by contacting payer directly.
• Review and process work queues related to Patient Access pre-visit or urgent/emergent admissions, per department guidelines.
• Review of accounts falling within the work queues to ensure the insurance information contains accurate policy ID#s, Group Name and Numbers, Subscriber information, Authorization numbers, as well as correct payer and Coordination of benefits prior to date of service.
• Accurately document actions taken in the system of record to drive effective follow-up and ensure an accurate audit trail.
• Maintain ongoing knowledge of authorization requirements and payer guidelines. Maintain a proficient knowledge of Medicare (CMS) guidelines as it relates to admissions and outpatient services. Ensuring compliance with admissions forms, benefit entitlement verification, and billing requirements
• Ensure accurate completion of MSPQ prior to date of service.
• Work with payers to ensure authorization is in place; initiating the auth when appropriate.
• Coordinate efforts with Financial Advocates to secure payer source current and future visits.
• Monitor work queues to identify late add-on accounts and complete financial clearance procedures prior to services to avoid unauthorized procedures from being performed.

Qualifications

• High school diploma, continued education preferred

• External and Internal Non-Patient Access Candidates: Pass Patient Academy with passing score of 85% or higher

• Previous completion and passing of Patient Access Advocate II and III Advancement test.

• A minimum of 2 years of work experiences in healthcare setting within Patient Access and/or billing plus strong customer service background.

• Strong knowledge and understanding of insurance and financial processing of accounts.

• Proficient in EPIC ADT system

• Specialty Certifications: CHAA, CHAM or other industry equivalent certification preferred

• Pass annual competency exam for all areas of responsibility.

• Requires general knowledge of the customer encounter process which may include registration, contract requirements, and coordination of benefits.

• Knowledge in Microsoft Office Products.

• Demonstrated strong keyboarding skills, ensuring efficient data entry and documentation.

• Pass EPIC proficiency test required with a 85% score at completion of the Epic Training class.

• Candidates must be at least 18 years of age at the time of hire

• All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

• Wellness

• Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

• Why work at Presbyterian?

• As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

• About Presbyterian Healthcare Services

• Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

• Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

• AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

• We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services