Patient Access Specialist

Reports to the Supervisor or Manager. Follows established Beacon policies and procedures to admit and register patients for services in a professional and courteous manner. Completes the pre-registration, registration, insurance verification and must be able to accurately decipher eligibility responses and relay that information back to the patient. Ability to communicate effectively with internal and external customers. Collects applicable co-payments, deductibles, and obtains insurance information from the patient. Verifies insurance benefits, posts applicable co-payments, deductibles, and performs daily cash balancing procedures. Obtains all required signatures on paperwork and performs clerical duties as necessary. Must maintain regulatory and functional knowledge of all information required which ensures timely and accurate reporting/billing.

MISSION, VALUES and SERVICE GOALS

• MISSION: We deliver outstanding care, inspire health, and connect with heart.
• VALUES: Trust. Respect. Integrity. Compassion.
• SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team

Scheduling/Registration/Pre-Registration/Patient Check In/Check Out

• Schedule patients with providers, utilize multiple scheduling templates and maintain appointments with provider(s) rotation. Both in-person and through digital platform options.
• Complete patient screening and sign in process while striving to minimize patient waiting time. Ensure patients are informed of delays and the status of their waiting times.
• Check patients in for their appointments and handle any special needs of the patient.
• Accurately capture all necessary patient data, insurance and other information pertinent to the visit that will allow for proper claim processing procedures.
• Review orders for completeness.
• Print or attach orders to the correct account from WQM as needed.
• Assist patient in obtaining an order when one was not sent or request a complete order when needed.
• Scan registration documents into the EMR.
• Verify the patient's insurance eligibility and benefits in Experian.
• Review Experian alerts to correct any insurance errors in Cerner PM Office or Cerner Practice Management.
• Run Experian estimate to accurately identify co-pay, co-insurance, and/or patient deductible.
• Process payment in Rev Spring and generate receipt.
• Maintain cash drawer in order to make the appropriate change for patients.
• Balance and reconcile the cash drawer at the end of the shift.
• Refer self-pay patients to the eligibility specialist.
• Refer patients to the financial counselor for payment arrangements.
• Check Medicare Medical Necessity in Cerner Stand Alone for non-scheduled procedures and produces an ABN when appropriate.
• Adherence to any specific payer requirements such as MSPQ: Medicare Secondary Payer Questionnaire completion.
• Consistent daily monitoring of work queues, schedules and reports to assure accuracy of scheduling, authorization capture, insurance eligibility and timely resolution of account alerts.
• Protect patient confidentiality when handling orders and check in documents.
• Obtain signatures by E-signature or paper for the consent to treat, privacy notice and all other necessary forms.
• Assures patients are checked out and the necessary follow-up appointments are scheduled with accuracy based on established office guidelines.
• Provides patients with required wellness paperwork for completion and route to scan, generates proof of appointment for employer or school.
• Responsible for completion of Insurance payer forms: Medicaid patient add form, etc.
• Using numerous software platforms (multiple EMR’s, insurance websites, referral database, scheduling software, etc.) to conduct tasks for patient care.
• Prepares and opens office reception area for patient's arrival. Keeping the area tidy and welcoming throughout the day. Performs close of office ensuring all patients have been checked-out.

Notifies the appropriate area of the patient’s arrival and ensures that the patient is escorted to the appropriate location by:

• Cheerfully greet patients, family members and visitors and make every effort to ensure that they are processed or directed to the appropriate area in a timely manner.
• Notify the department of the patient’s arrival.
• Arrange for an escort to assist the patient to the assigned area (by wheelchair or walking with the patient).
• Acting as a representative of Beacon Health System and striving to make a good first impression.

Performs other functions to maintain personal competence and contribute to the overall effectiveness of the department by:

• Provide world class service at all times.
• Assist the department to meet or exceed its quality assurance goals.
• Strive to accurately process an optimal number of registrations or pre-registrations during ones shift.
• Identify and communicate problems to appropriate supervisory personnel and participate in corrective actions.
• Maintain records, reports and files as required by departmental policies and procedures.
• Perform time of service collections effectively by achieving assigned collections goals.
• Complete all other job duties as assigned.

Communication/Working Relationships/Training

• Answer questions and give information based on department and Beacon guidelines.
• Notify departments when there are delays or late appointments and keep patients informed of wait times.
• Complete all mandatory in-services in a timely manner and attend scheduled departmental meetings.
• Exhibit courtesy and respect when dealing with others.
• Answer all incoming calls within three rings and ensure that standard departmental protocols are used.
• Anticipates needs of co-workers and department and respond appropriately. Adapt to changing needs and requirements of the job.
• Keeps the Manager/Supervisor apprised of all issues which have the potential for a disruption of service.

ORGANIZATIONAL RESPONSIBILITIES

Associate complies with the following organizational requirements:

• Attends and participates in department meetings and is accountable for all information shared.
• Completes mandatory education, annual competencies and department specific education within established timeframes.
• Completes annual employee health requirements within established timeframes.
• Maintains license/certification, registration in good standing throughout fiscal year.
• Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
• Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
• Adheres to regulatory agency requirements, survey process and compliance.
• Complies with established organization and department policies.
• Available to work overtime in addition to working additional or other shifts and schedules when required.

Education and Experience

The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a high school diploma (or equivalent). Experience is preferred.

Knowledge & Skills

• Possesses strong customer service, communication, organizational and analytical skills.
• Demonstrates the verbal communication skills needed to communicate in a clear and effective manner when conducting patient interviews, answering patient’s questions and communicating with other departments and physician offices.
• Ability to handle a fast-paced environment and prioritize tasks based on importance.
• Requires basic office and keyboarding skills.
• Requires effective telephone skills.
• Computer skills required to complete tasks in an accurate and efficient manner. Relevant software applications knowledge preferred. (Cerner Practice Management, Cerner PM Office, Rev Spring, and Experian). Adaptable to new technology.
• Requires a complete understanding of Point of Service Collections. Specifically must understand why it is necessary and must be able to effectively communicate this to the patient.
• Requires basic knowledge of medical terminology, commercial and managed care insurance coverage.
• Demonstrates the interpersonal skills necessary to interact effectively with patients from various backgrounds in a professional, enthusiastic, courteous, friendly, caring and sincere manner. Also demonstrates the ability to maintain effective working relationships with other departments, physicians and their office staff.
• Good listening skills are required. Sensitivity to individuals needs is expected.
• Requires ability to utilize good judgment and maintain one's composure in stressful situations.

Working Conditions

• Works in a medical office environment.
• Assigned hours within your shift, starting time, or days of work are subject to change based on departmental and/or organizational needs.
• Must be effective in a quality-focused, multi-priority environment that frequently deals with stressful situations and promptly completes accurate registrations.

Physical Demands

• Requires the physical ability and stamina to perform the essential functions of the position.
• Sitting for long periods of time in front of a computer monitor.