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Patient Access Specialist in Union, SC at Spartanburg Regional Healthcare System

Date Posted: 5/9/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Union, SC
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    5/9/2019

Job Description

Patient Access Specialist

Position Summary

The Patient Access Specialist position is a higher level position within the Patient Access Services Department which includes duties of registration, insurance verifications, service estimates, onboarding of new associates, coordinating the initial patient experience, and being an advocate for both the patient and the health care facility.

Core Job Responsibilities

1. Assists with the onboarding of new associates

2. Cross training of current associates

3. Responsible for all patient and claim edits for accuracy and compliance with all government and commercial carriers to ensure a clean claim submission

4. Works as a liaison with Centralized Referral Center or assigned entity to ensure prior-authorizations have been obtained to payment has been obtained

5. Complete and/or process patient payments for account posting accuracy

6. Prevention of denials by ensuring a quality registration and work queue follow up in HIS system

7. Accurately estimates the cost of services for patient inquires via the HIS system estimate tool

8. Serves as a point of escalation for Patient Access Representatives in resolving more complex customer service concerns and maintains confidentiality and compliance while seeking expeditious resolution.

9. Performs patient access activities in support of multiple outpatient ancillary departments and inpatient units.

10. Works with Patient Financial Services to resolve complex customer service complaints

11. Works with external departments and Physician Practices to resolve denied claims or resubmit claims as needed

12. Works with external departments to coordinate patient care, including diagnostic imaging, lab work, etc.

13. Performs all duties highlighted in the Patient Access Representative Job description at an advanced level of proficiency.

14. Other duties as assigned

Minimum Requirements
Education
•        High School Diploma or equivalent
•        Preferred Associates Degree
Experience

  • Minimum three years' experience in healthcare access, financial and/or customer service
  • Demonstratable experience and the ability to produce and adhere to measurable strategic departmental and system goals in relation to the expected process of patient throughout

Other skills and abilities

  • Strong grasp of financial analysis of insurance benefits for pricing transparency
  • Comfortable handling sensitive and confidential information and processes as it relates to clinical and financial matters
  • Focused knowledge of performance measures for point of service cash collection in relation to departmental and system annual goals
  • Excellent understanding of insurance and medical terminology.
  • Ensures proper utilization of computer systems to facilitate efficient and effective work flow processes
  • Prioritizing work responsibilities is a must in order to facilitate effective time management for task completion
  • Solid Microsoft Office skills required with a focus on Excel and Word.