Patient Access Specialist I - ED Services

Overview

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.

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 patient's 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.
• Maintains confidentiality of patient information, in accordance with WHS policy and HIPAA regulations.
• Resolves error and applicable Claim, DNB, and Patient WorkQueues.

Customer Service

• Greets all guests 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.

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.
• 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.
• Identifies and resolves Payor Denials as indicated.

General

• Observes work hours and provides proper notice of absences, tardiness, and 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.

Qualifications

Required Minimum Education: High school diploma required; Associate's Degree preferred.

Required Minimum Experience: Minimum 1 year experience in healthcare, or institutional (corporate) work setting required. Computer/data entry experience required; Epic experience preferred.

Required Minimum Skills: Ability to communicate with various members of the healthcare team. Effective communication skills (both written and verbal), attention to detail, self-directed and a positive attitude are essential. Effective problem solving and critical thinking skills. Working knowledge of patient registration systems and intermediate Microsoft Office Suite are preferred.