Patient Access Specialist I ED Services SP SG WG

Job Summary

This job is typically the first point of contact for patients presenting to the Emergency Department and must ensure a pleasant experience for patients and visitors. Strictly follows EMTALA protocols prior to performing registration of emergency room patients. Gathers appropriate identification for patient and confirms all patient demographics to validate patient identity. Conducts intensive screening of all Medicare, Medicaid and managed care patients to identify network status and coordination of benefits. Obtains all necessary customer consents/attestations. Responds to customer requests and answers questions regarding various service and account information. Analyzes and rectifies customer concerns using established procedures. Uses computer to access and/or update customer records. Collects patient portions, verifies, and posts transactions. Follows established procedures for processing receipts, cash etc. Sorts and files various documents. Assists with general hospital information and directions to departments within and outside of the WHS facility. Establishes financial arrangements to reduce financial risk for WHS, helping to ensure that WellStar is reimbursed for its services.

Core Responsibilities and Essential Functions

Quality/Safety

• Interviews each patient or representatives to obtain complete and accurate demographic, financial and insurance information.
• Enters all patient information into the registration system.
• Obtains all necessary signatures and is knowledgeable regarding any special forms that may be required by the patients third party payer.
• Reads physicians orders to determine the procedures requested and to instruct patients accordingly.
• Escorts or arranges to have patient escorted to assigned room.
• Makes corrections and updates patient account information in computer.
• Obtains new medical record numbers for newborn admissions and other new patients.
• Documents thorough explanatory notes on patient accounts, concerning any non-routine circumstances, clarifying special billing processes.
• Maintains a working knowledge of available information system capabilities and performs all system applications that are required.
• Understands the admission, outpatient and emergency registration process.
• Maintains confidentiality of patient information, in accordance with WHS policy and HIPPA regulations.
• Consistently demonstrates the ability to organize work, recognizes and establishes appropriate work priorities, and completes work in a productive manner, without creating backlogs.
• Maintains proficiency in data entry skills.
• Resolves error and applicable Claim, DNB, and Patient WorkQueues.

Customer Service

• Greets all guest with a positive and professional attitude.
• Receives patients valuables for safekeeping in the hospital safe.
• Answers incoming phone calls and follows through with requests made.
• Maintains courteous and cooperative working relationships with WHS management, patients, physicians, other professional contacts, and the general public.
• Demonstrates ability to tactfully handle difficult situations.
• Presents a well-groomed and professional image in coordination with dept/ hospital dress codes.

Budget/Financial

• Attempts to collect the estimated self-pay balance of all inpatient, outpatient and ER accounts, at the earliest possible collection control point.
• Completes financial evaluation forms to document guarantors' income, expenses, assets and liabilities.
• Identifies those patients without adequate insurance coverage.
• Makes personal contact with patient or guarantor to determine guarantor's ability to pay non-covered charges, as well as to determine potential eligibility for financial assistance programs (namely Medicaid).
• Maintains a list of health care financial assistance programs and the eligibility requirements for each program.
• Refers patients/guarantors to sources of outside funding assistance, as needed.
• Works efficiently and accurately within designated time frames to ensure a continuity of information and cash flow.
• Documents concise and understandable notes regarding all self-pay account collection activity, as well as each patient or guarantor interaction.
• Coordinates financial counseling activities with PAS Financial Counselor, Registration, Utilization Review, Nursing, Social Services, and Patient Financial Services.
• Verifies insurance coverage and benefits.
• Exceeds monthly quota on a consistent basis.
• Formally reports results of self-pay collection activity to direct supervisor, on a daily basis or according to policy.
• Provides feedback to PAS management concerning self-pay collection and data integrity issues.
• Responsible for completion of appropriate error/issues in WorkQueues.
• Identifies and resolves Payor Denials as indicated.

General

• Observes work hours and provides proper notice of absences, tardies work schedule changes.
• Attends select departmental meetings at the request of WHS Management.
• Completes monthly, quarterly, and annual mandatory training as required.
• Performs other duties as assigned.
• Complies with all WellStar Health System policies, standards of work, and code of conduct.