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Patient Access Specialist Full-time

at in West Virginia (Published at 11-09-2019)

Greets and receives patients into the health care
facility. Responsible for accurate and timely processing of patient demographics
and insurance information. Communicates and supports hospital departments
using scheduling system as appropriate. Obtains electronic signature for
consent to treat and patient financial obligation. Provides excellent
customer service and uses strong written/verbal communication skills. This
position is the first impression of WVU Healthcare to the patient.
MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1.
High School diploma or
equivalent.
PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1.
Associate
degree in a related medical field such as medical assisting or medical office
administration.
EXPERIENCE:
1.
Experience in a medical
office setting.
CORE DUTIES AND RESPONSIBILITIES: The statements described
here are intended to describe the general nature of work being performed by
people assigned to this position. They are not intended to be
constructed as an all-inclusive list of all responsibilities and
duties. Other duties may be assigned.
1.
Obtains
demographic/billing/insurance information from patient/family/legal guardian
and enters into the registration/billing systems for service and claim
processing and scans insurance cards & photo identification.
2.
May
complete managed care responsibilities in regard to obtaining
pre-certification and authorizations.
3.
Prepares
WVU Medicine standard consent form, notice of privacy practice and/or other
necessary paperwork related to registration and presents to
patient/family/legal guardian for signatures. Obtains electronic
signature for consent to treat and patient financial obligations.
4.
Collects
deposits/co-payments/deductibles/patient liability payments when applicable, provides
patient receipt and documents payment in the registration/billing systems.
5.
Directs patients needing
financial assistance to speak with a Financial Counselor.
6.
Prepares armband for
patient identification.
7.
Balances daily receipts
and cash drawer for patient payments as needed.
8.
Follows up on accounts as
indicated by system flags (courtesy dismissal/comments/red stickers).
9.
May
initiate auto accident liability coverage. Identifies all patients involved
in an auto accident and obtains all pertinent information regarding medical
or non-fault liability and documents in registration/billing systems.
10.
May
initiate ERSD (end stage renal disease) screening. Identifies ESRD
patients and obtains all pertinent information regarding coverage by SSI and
documents in the registration/billing systems.
11.
May initiate Veterans
Administration eligibility screening. Identifies all VA eligible
patients and coordinated admission/treatment with VA and documents in the
registration/billing systems.
12.
May initiate Black Lung
SSI screening. Identifies all patients covered under Black Lung and
documents in the registration/billing systems.
13.
May initiate Workers
Compensation screening. Accurately identifies all patients seeking
treatment for work related injuries. Assists in completion of
appropriate paperwork and documents in the registration/billing systems.
14.
Initiates MSPQ (Medicare
secondary payer questionnaire). Obtains all information regarding
MSPQ. Documents in registration/billing system all information required
on the MSPQ.
15.
Maintains confidentiality
according to policy and HIPAA when interacting with patients, physicians,
families, co-workers and the public regarding demographic/clinical/financial
information
16.
Provides to the patient,
information concerning insurance, payment of bills and hospital
procedures. Consistently maintains current knowledge of major payer
payment provisions.
17.
Performs medical necessity
checks and completes Advanced Beneficiary Notice as needed.
18.
Answers phone calls in a
professional and courteous manner. Uses phone system in correct manner.
19.
Schedules, reschedules, or
cancels patients in accordance with hospital workflows.
20.
Checks for order
completeness and validate order against scheduled service.
21.
Communicates with and
supports hospital departments using the scheduling system.
22.
Follows hospital, state, and federal guidelines for ensuring
safe environment for workers, patients, and the public. Ensures compliance by
staff to hospital, governmental, and insurance regulations.
23.
Complies with Notices of Privacy Practices, and the Patients
Rights and Responsibilities and cooperate with the WVUH Corporate Compliance Program
during employment.
24.
Communicates and interacts with clients, families, visitors,
physicians, departmental, and hospital staff and the public in general in a
manner that demonstrates professionalism and concern for the individuals
need(s).
25.
Participates in the processes to assess and improve the services
provided and compliance with regulatory requirements. Reports results of
assessments and improvement processes to the appropriate administrative
levels.
PHYSICAL REQUIREMENTS: The physical demands described here are representative of those
that must be met by an employee to successfully perform the essential
functions of this job. Reasonable accommodations may be made to enable
individuals with disabilities to perform the essential functions.
1.
Frequent walking,
standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping,
and feeling are necessary body movements utilized in performing duties
throughout the work shift.
2.
Visual acuity must be
within normal range.
3.
Must be able to exert in
excess of 50 pounds of force occasionally, and/or up to 25 pounds of force
frequently, and/or up to 10 pounds of force constantly to move objects.
4.
Must have manual dexterity
to operate keyboards, fax machines, telephones, and other business equipment.
5.
Must have the ability to
move throughout the work area and clinic area.
6.
Must be able to sit or
stand for extended periods of time.
8.
Must have reading and
comprehension ability.
WORKING ENVIRONMENT: The work environment characteristics described here are
representative of those an employee encounters while performing the essential
functions of this job. Reasonable accommodations may be made to enable
individuals with disabilities to perform the essential functions.
1.
Must be capable of performing assigned task despite frequent
interruptions.
2.
Must be capable of working within
a confined office space and under fluorescent lighting.
3.
Must have ability to maintain concentration
in and around noise from office machinery such as a copier or printer.
4.
High volume, fast paced
environment.
5.
Exposure to communicable disease.
6.
Interacts with patients, medical
staff, and support staff daily on a continual basis.
SKILLS AND ABILITIES:
1.
Ability to accurately
utilize applicable computer software and equipment for access processing
& demonstrates ability to follow down time procedures.
2.
Demonstrate knowledge of procedure to report and/or document unsafe/hazardous
conditions, incidents and defective equipment in compliance with hospital
policy.
3.
Requires ability to perform repetitious duties throughout the
shift.
4.
Requires considerable attention to detail, the ability to be
organized and to be able to perform multiple tasks simultaneously.
5.
Requires the ability to memorize a considerable amount of
information, and to be able to reference information not retained from
written sources or from appropriate personnel.
6.
Requires the ability to understand medical insurance
requirements for payment and basic knowledge of covered services.
7.
Must be able to work with a variety of personality types and
interact with individuals with various levels of education, capabilities and
communication skills.
8.
Must demonstrate ability to use tact and diplomacy in dealing
with physicians, patients, and families.
9.
Excellent communication skills (written and verbal).
10.
Basic knowledge of medical terminology preferred.
11.
Basic knowledge of third party payers preferred.
12.
General knowledge of time of service collection procedures
preferred.
13.
Demonstrates ability to follow established computer downtime
procedures.
14.
Ability to understand written and oral communication.
Date Reviewed/Revised: May 2019


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