Central Access Specialist - Full-time
Job
Summary:
The Central Access Specialist I is an entry level position and is responsible for scheduling, securing patient demographic and insurance information; verifying insurance eligibility and benefits, verify pre-certification is obtained and/or validated; computing, communicating and obtaining patient collections and initiating the financial clearance process. Emphasis is scheduling patients greater than 3 to 5 days prior to the scheduled service date. In addition the Central Access Specialist I will complete insurance verification/pre-registration and financial clearance for special admissions. Central Access Specialist I manages heavy call and schedule volumes. Position is responsible for notifying patients of their financial obligation and collecting co-pays, deductibles, deposits and other identified out-of-pocket liabilities or deposits on accounts as required and supporting their department in meeting the pre-collections goals defined by Revenue Cycle management. This also includes a review of past account balances, notifying patient of additional financial responsibility, and attempt collection of these balances. Review accounts with inadequate financial coverage for the purpose of coordinating with the Central Access Financial Advocate. The Central Access Specialist I demonstrates professionalism as reflected by courteous actions, maintenance of confidentiality and appropriate presentation of self; consistently exhibits excellent oral and written communication skills; possess the knowledge and skills necessary to provide interactive communications appropriate to the age of the patient being served; interact appropriately with third party payers and other departments; and have the ability to relate well to people of a broad socio-economic mix. Strong organizational skills, ability to multitask, work in a fast pace environment, manage a multi-line phone system and a commitment to teamwork are essential. Must have ability to work closely in a clinical setting involving some stressful situations, Education:
Required:
High School Diploma or equivalent Preferred:
Prefer graduate of Medical Secretary Program
Experience:
Required:
Demonstrated ability to read, write, arithmetic, multiplication/division including fractions and decimals. Strong computer skills, excellent customer service skills, interpersonal communication and telephone etiquette are required. Demonstrate ability to multitask and manage high volumes. Computer, fax machine, copier, multiline telephone. Preferred:
Knowledge of basic registration and third party payer preferred. Preference for work experience in a physician front office operations or insurance/healthcare call center. Medical terminology, and basic knowledge base of CPT and ICD-9 codes, insurance coding and billing knowledge. Position Requirement(s):
License/Certification/Registration Required:
Preferred:
Certified Healthcare Access Associate from NAHAM
Essential Functions:
Answering incoming phone calls and scheduling outpatient appointments Pre-register scheduled patients by gathering all patient demographic and financial information. Verify insurance eligibility and benefits for scheduled outpatient and inpatient patients. Validate and initiate pre-certification. Compute patient liability. Communicate and initiate time of service collections. Review prior bad debts and request payment of outstanding prior bad debt . Alert Financial Advocates of accounts with financial clearance issues. Document patient liability and financial clearance status to ensure timely processing at the point of service. Complete pre-registration, insurance verification and financial clearance for special admission and transfer patients. Responsibilities Scheduling/Pre-register patients Access department schedules and pre-registration work list to contact patients via inbound and outbound calls to pre-register patients for future date services. Follow established guidelines to pre-register patients utilizing the Erlanger online pre-registration form. Ensure patient medical record numbers are correct for the patient scheduled by validating patient name, social security number, and birth date and comparing to the master patient index. Collect and enter patient demographic and insurance information into appropriate registration screens. Verify insurance eligibility and benefits Verify insurance eligibility and benefits to by utilizing integrated insurance verification system, payer websites, and telephone calls to payers. Document insurance eligibility and benefits in the appropriate registration insurance verification and benefits fields. Validate pre-certification requirements and pre-certification status. Document pre-certification status in registration pre-certification field as outlined in department procedures. Computer, communication and collect patient liability Calculate patient liability using insurance verification information and pricing estimator tools. Document patient liability in appropriate fields in patient registration system as outlined in department procedures. Compute total outstanding prior bad debts amounts. Communicate estimated liability including current and prior bad debt to patient. Request payment of total patient liability. Process and document patient financial liabilities, estimations, and payments as defined by central access procedures Demonstrated/acknowledges how to provide price estimations and documentation. Document financial clearance issues as defined in the department procedures. Transfer patients who cannot be financially cleared by paying payment at the time of pre-registration or time of service to the Pre-Access Financial Advocate. Assess patient financial clearance status. Assess patient financial clearance including pre-registration, insurance verification, pre-certification, prior bad debts, and collection of patient liability. Document patient financial clearance status as outlined in department procedures. Maintain effective communication and quality with members of the healthcare team. Complete productivity reports as requested by management. Review daily work as requested by management. Remain current on changes in Department and Erlanger Policies and Procedures. Serve as a liaison with the physician and/or physician office staff utilizing excellent guest relations. Collaborate with other department and outside agencies to meet the needs of the patient and the organization. Notify the supervisory team of incidents of errors. Ensure designated telephone hold time is maintained through monitoring of queue and answering the telephone timely. Enter appropriate activity codes Complete insurance verifications and financial clearance on special admissions or transfer requests. Receive demographic and clinical information from clinical or financial person requesting evaluation. Contact physician or transferring department for any additional information required. Verify insurance benefits with special attention paid to payment limitations and maximum life time benefits. Calculate cost of service. Estimate reimbursement. Complete evaluation sheet. Return completed information to requesting party. Maintain confidentiality of information of the department. Maintain confidentiality of departmental information according to established procedures with no reported errors. Release confidential information only in accordance with the confidentiality policy and/or approval of the Director. Contribute to the efficient operations of the department. Complete special projects as assigned according to the established time frames. Prepares and maintains reports of results as requested. Identifies and reports equipment problems which require maintenance or repair. Facilitate the efficient operations of the department by answering the telephone and assisting callers or visitors in any way possible. Perform other duties as assigned. Assist in delivering high quality health care services in a professional, compassionate, and courteous manner while respecting the dignity and individuality of each person who comes in contact with the organization by following Erlanger's Take Pride Standards in accordance to its Mission, Vision, Core Values, Keys to Service, Steps to Service, and Professional Appearance and Conduct. Maintains patient privacy and confidentiality at all times according to established procedures. Follow the Professional Appearance and Conduct and the Erlanger departmental dress code. Communicates effectively and courteously answering assigned telephone lines within three rings identifying self at all times. Assist visitors and patients in giving directions and information. Communicate effectively and courteously with visitors, physicians, patients, and employees. Introduces self and position to patient, families and visitors at all times. Assess environment for safety hazards which could harm patients, visitors, or other hospital employees and report hazards to appropriate supervisors. Collaborate with departments and outside agencies to meet the identified needs of the patients and organization. Knowledge and performance of the Code of Conduct Standards The incumbent demonstrates a commitment to high level of professional and ethical standards in his/her daily activities, consistent with the Code of Conduct and related to Erlanger policies. The incumbent maintains integrity in business activities by following legal standards, maintaining confidentiality of patient and business information and reporting known or suspected misconduct. The incumbent has completed the required annual general compliance training and any department specific training, as appropriate. The employee honors Erlanger's Mission Statement, Vision Statement, and Core Values. The incumbent understands:
That Erlanger provides the highest quality of care to the community through respect, dignity, and compassion regardless of race, creed, national origin or the individual's ability to pay and; That Erlanger provides leadership in pioneering new services through increased allocation of resources for research and education. Mission:
To serve the community by delivering a positive experience to our patients, families, and physicians by expediting care in a timely, personalized and compassionate manner while honoring Erlangers core values of H.E.A.R.T. ; Ensuring the integrity of all job responsibilities are executed with the highest of quality standards, confidentiality, and security of patient information, identity, which enhance the hospitals revenue cycle operations throughout all registration functions and all its support processes. Vision:
Patient Access Services strives for excellence in quality, integrity, efficiency, and customer service through H.E.A.R.T. R.E.S.P.E.C.T.:
We will fulfill the mission and vision by adhering to the Standards of R.E.S.P.E.C.T. Responsiveness Enthusiasm Safety Privacy Excellence Communication Teamwork '17265
. Apply now!Estimated Salary: $20 to $28 per hour based on qualifications.
Summary:
The Central Access Specialist I is an entry level position and is responsible for scheduling, securing patient demographic and insurance information; verifying insurance eligibility and benefits, verify pre-certification is obtained and/or validated; computing, communicating and obtaining patient collections and initiating the financial clearance process. Emphasis is scheduling patients greater than 3 to 5 days prior to the scheduled service date. In addition the Central Access Specialist I will complete insurance verification/pre-registration and financial clearance for special admissions. Central Access Specialist I manages heavy call and schedule volumes. Position is responsible for notifying patients of their financial obligation and collecting co-pays, deductibles, deposits and other identified out-of-pocket liabilities or deposits on accounts as required and supporting their department in meeting the pre-collections goals defined by Revenue Cycle management. This also includes a review of past account balances, notifying patient of additional financial responsibility, and attempt collection of these balances. Review accounts with inadequate financial coverage for the purpose of coordinating with the Central Access Financial Advocate. The Central Access Specialist I demonstrates professionalism as reflected by courteous actions, maintenance of confidentiality and appropriate presentation of self; consistently exhibits excellent oral and written communication skills; possess the knowledge and skills necessary to provide interactive communications appropriate to the age of the patient being served; interact appropriately with third party payers and other departments; and have the ability to relate well to people of a broad socio-economic mix. Strong organizational skills, ability to multitask, work in a fast pace environment, manage a multi-line phone system and a commitment to teamwork are essential. Must have ability to work closely in a clinical setting involving some stressful situations, Education:
Required:
High School Diploma or equivalent Preferred:
Prefer graduate of Medical Secretary Program
Experience:
Required:
Demonstrated ability to read, write, arithmetic, multiplication/division including fractions and decimals. Strong computer skills, excellent customer service skills, interpersonal communication and telephone etiquette are required. Demonstrate ability to multitask and manage high volumes. Computer, fax machine, copier, multiline telephone. Preferred:
Knowledge of basic registration and third party payer preferred. Preference for work experience in a physician front office operations or insurance/healthcare call center. Medical terminology, and basic knowledge base of CPT and ICD-9 codes, insurance coding and billing knowledge. Position Requirement(s):
License/Certification/Registration Required:
Preferred:
Certified Healthcare Access Associate from NAHAM
Essential Functions:
Answering incoming phone calls and scheduling outpatient appointments Pre-register scheduled patients by gathering all patient demographic and financial information. Verify insurance eligibility and benefits for scheduled outpatient and inpatient patients. Validate and initiate pre-certification. Compute patient liability. Communicate and initiate time of service collections. Review prior bad debts and request payment of outstanding prior bad debt . Alert Financial Advocates of accounts with financial clearance issues. Document patient liability and financial clearance status to ensure timely processing at the point of service. Complete pre-registration, insurance verification and financial clearance for special admission and transfer patients. Responsibilities Scheduling/Pre-register patients Access department schedules and pre-registration work list to contact patients via inbound and outbound calls to pre-register patients for future date services. Follow established guidelines to pre-register patients utilizing the Erlanger online pre-registration form. Ensure patient medical record numbers are correct for the patient scheduled by validating patient name, social security number, and birth date and comparing to the master patient index. Collect and enter patient demographic and insurance information into appropriate registration screens. Verify insurance eligibility and benefits Verify insurance eligibility and benefits to by utilizing integrated insurance verification system, payer websites, and telephone calls to payers. Document insurance eligibility and benefits in the appropriate registration insurance verification and benefits fields. Validate pre-certification requirements and pre-certification status. Document pre-certification status in registration pre-certification field as outlined in department procedures. Computer, communication and collect patient liability Calculate patient liability using insurance verification information and pricing estimator tools. Document patient liability in appropriate fields in patient registration system as outlined in department procedures. Compute total outstanding prior bad debts amounts. Communicate estimated liability including current and prior bad debt to patient. Request payment of total patient liability. Process and document patient financial liabilities, estimations, and payments as defined by central access procedures Demonstrated/acknowledges how to provide price estimations and documentation. Document financial clearance issues as defined in the department procedures. Transfer patients who cannot be financially cleared by paying payment at the time of pre-registration or time of service to the Pre-Access Financial Advocate. Assess patient financial clearance status. Assess patient financial clearance including pre-registration, insurance verification, pre-certification, prior bad debts, and collection of patient liability. Document patient financial clearance status as outlined in department procedures. Maintain effective communication and quality with members of the healthcare team. Complete productivity reports as requested by management. Review daily work as requested by management. Remain current on changes in Department and Erlanger Policies and Procedures. Serve as a liaison with the physician and/or physician office staff utilizing excellent guest relations. Collaborate with other department and outside agencies to meet the needs of the patient and the organization. Notify the supervisory team of incidents of errors. Ensure designated telephone hold time is maintained through monitoring of queue and answering the telephone timely. Enter appropriate activity codes Complete insurance verifications and financial clearance on special admissions or transfer requests. Receive demographic and clinical information from clinical or financial person requesting evaluation. Contact physician or transferring department for any additional information required. Verify insurance benefits with special attention paid to payment limitations and maximum life time benefits. Calculate cost of service. Estimate reimbursement. Complete evaluation sheet. Return completed information to requesting party. Maintain confidentiality of information of the department. Maintain confidentiality of departmental information according to established procedures with no reported errors. Release confidential information only in accordance with the confidentiality policy and/or approval of the Director. Contribute to the efficient operations of the department. Complete special projects as assigned according to the established time frames. Prepares and maintains reports of results as requested. Identifies and reports equipment problems which require maintenance or repair. Facilitate the efficient operations of the department by answering the telephone and assisting callers or visitors in any way possible. Perform other duties as assigned. Assist in delivering high quality health care services in a professional, compassionate, and courteous manner while respecting the dignity and individuality of each person who comes in contact with the organization by following Erlanger's Take Pride Standards in accordance to its Mission, Vision, Core Values, Keys to Service, Steps to Service, and Professional Appearance and Conduct. Maintains patient privacy and confidentiality at all times according to established procedures. Follow the Professional Appearance and Conduct and the Erlanger departmental dress code. Communicates effectively and courteously answering assigned telephone lines within three rings identifying self at all times. Assist visitors and patients in giving directions and information. Communicate effectively and courteously with visitors, physicians, patients, and employees. Introduces self and position to patient, families and visitors at all times. Assess environment for safety hazards which could harm patients, visitors, or other hospital employees and report hazards to appropriate supervisors. Collaborate with departments and outside agencies to meet the identified needs of the patients and organization. Knowledge and performance of the Code of Conduct Standards The incumbent demonstrates a commitment to high level of professional and ethical standards in his/her daily activities, consistent with the Code of Conduct and related to Erlanger policies. The incumbent maintains integrity in business activities by following legal standards, maintaining confidentiality of patient and business information and reporting known or suspected misconduct. The incumbent has completed the required annual general compliance training and any department specific training, as appropriate. The employee honors Erlanger's Mission Statement, Vision Statement, and Core Values. The incumbent understands:
That Erlanger provides the highest quality of care to the community through respect, dignity, and compassion regardless of race, creed, national origin or the individual's ability to pay and; That Erlanger provides leadership in pioneering new services through increased allocation of resources for research and education. Mission:
To serve the community by delivering a positive experience to our patients, families, and physicians by expediting care in a timely, personalized and compassionate manner while honoring Erlangers core values of H.E.A.R.T. ; Ensuring the integrity of all job responsibilities are executed with the highest of quality standards, confidentiality, and security of patient information, identity, which enhance the hospitals revenue cycle operations throughout all registration functions and all its support processes. Vision:
Patient Access Services strives for excellence in quality, integrity, efficiency, and customer service through H.E.A.R.T. R.E.S.P.E.C.T.:
We will fulfill the mission and vision by adhering to the Standards of R.E.S.P.E.C.T. Responsiveness Enthusiasm Safety Privacy Excellence Communication Teamwork '17265
. Apply now!Estimated Salary: $20 to $28 per hour based on qualifications.
|
|
 | |
