Patient Access Specialist II

Location: Kent Campus Hospital

Status:Full Time 80 Hours

Shift: Variable

General Summary:

The Patient Access Specialist II is the second level role of the Patient Access career path.

Under the supervision of the Patient Access, Supervisor and Team Lead, the Patient Access Specialist II (PAS II) performs complete and accurate registration and admissions functions to provide information for continuity of care and revenue cycle efficiency. In addition to proper registration, the PAS II is responsible to resolve eligibility and authorization issues with accounts. The PAS II assists with the training of new employees and provides cross-support in other Patient Access areas within the home department.

The PAS II must demonstrate competence in each essential duty to become eligible for the Team Lead position. A minimum of three years revenue cycle experience is required for consideration for the Team Lead.

Responsibilities:

• Assists with training as needed.
• Assist peers with more complicated and complex functions.
• Completes direct admissions as needed (when applicable)
• Review and Resolve account errors in assigned work queues.
• System(s) Super User
• Timely and precise completion of each registration, following all department processes and procedures. Must verify that all demographic and insurance information is accurate; utilize Epic, payer websites or telephone for insurance verification. Obtain current copies of insurance cards and photo identification. Secures patient signatures for required forms.
• Enter data related to procedures, tests, and diagnoses (when applicable). Determines the need for medical necessity and follows the advanced beneficiary notice process when appropriate based on pre-established guidelines.
• Obtains and verify the accuracy of physician orders for tests and procedures to minimize risk to hospital reimbursement.
• Identify the patient using two factor identification. Complies with EMTALA regulation when creating the quick registration account (when applicable).
• Ensure authorizations (pre-certifications, prior authorization, referrals) are obtained prior to service, as applicable. Notify supervisor of any insurance authorization issues.
• As appropriate, completes Medicare Secondary Payer questionnaire without errors to support compliance with CMS policies.
• Perform point of service collections: Responsible for meeting monthly collection goals, having financial conversations with patients as it relates to their co-payments, deductibles, co-insurance, deposit amounts and outstanding balances. Documents payments/actions in the EHR and provides the patient with a payment estimate (when applicable). Follows cash drawer balancing procedures, as appropriate, reconciles payments against deposit totals.
• Maintain qualitative and quantitative individual and team performance targets.
• Takes initiative to continuously learn all aspects of Patient Access II role to support progressive responsibility.
• Responds to disaster and mass casualty situations in a calm and appropriate fashion. Maintains and understands the emergency management processes and procedures specific to that unit.
• Adheres to department and system policies. Interact with co-workers, visitors, and other staff consistent with Bayhealth values.
• Scheduling (as applicable) – may need to schedule appointments, following procedures and protocols. Assist patients with referral needs in obtaining additional appointments with specialists, and insurance approval authorization for additional visits.
• Patient flow (as applicable) - maintain efficient patient flow in the registration and check-in process. Accurately complete reception duties in accordance with policies.
• All other duties as assigned within the scope and range of job responsibilities.
  
  

Required Education, Credential(s) and Experience:

• Education: High School Diploma or GED ; ;
• Credential(s): None Required ;
• Experience: Required:Two (2) years’ experience in a healthcare patient-facing role.
  
  

Preferred: Revenue Cycle experience.

Preferred Education, Credential(s) and Experience:

• Education: Associate Degree Associate Degree Business Administration Related field
• Credential(s):
• Experience:
  
  

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