Lead Patient Access Specialist

Baptist-Health-System; San Antonio (TX); On-site; USD 35,000 - 52,000; Full time

Job summary

Emerus is seeking a Patient Access Representative to act as a liaison among patients, payers, and the revenue cycle team. You will collect demographic data, verify insurance, secure payments, and support patient access quality measures.

The role requires a high school diploma, 3 years of registration/verification experience, and strong MS Office skills, with preferred ED experience. This is an on-site role supporting hospital operations and patient experience.

Qualifications

• 3 years patient registration and insurance verification experience in a health care setting.
• Emergency Department experience strongly preferred.
• Knowledge of various insurance plans (HMO, PPO, POS, Medicare, Medicaid) and payors.

Responsibilities

• Maintain EMTALA, DNV, HIPAA and all regulations in Admissions and Medical Records handling.
• Provide excellent customer service and build relationships with customers.
• Verify and enter complete demographic information to facilitate revenue cycle processing.
• Verify insurance benefits and ensure correct payor/plan in patient accounting system.
• Obtain insurance authorizations as required by plans.
• Pursue collections at the time of service in a customer-service oriented fashion.

Skills

Patient registration experience

Insurance verification experience

Emergency Department experience (pref)

Education

High School Diploma or GED

Tools

MS Office

Job description

About Us

Emerus is the nation's first and largest operator of small-format hospitals, also known as community or neighborhood hospitals. Emerus' leading national health system partners include Allegheny Health Network, Ascension, Baptist Health System, Baylor, Scott & White Health, Dignity Health St. Rose Dominican, The Hospitals of Providence, INTEGRIS and MultiCare. Our state-of-the-art hospitals are fully accredited and provide highly individualized care. From the moment a patient walks through the door, a team of exceptional medical professionals takes charge, treating patients with speed, compassion and expertise. Emerus' distinctive level of care earned the Guardian of Excellence Award for Superior Patient Experience in six of the past seven years. More information is available at www.emerus.com.

Position Overview

The purpose of this position is to serve as a liaison between patient/family, payers, Patient Financial Services, and other health care team members. You'll be asked to facilitate patient tracking and billing by obtaining/verifying accurate and complete demographic information, financially securing, and collecting out-of-pocket responsibility from guarantors to maximize hospital reimbursement.

Essential Job Functions

• Maintain compliance with EMTALA, DNV, HIPAA and all other hospital and government regulations applicable to the Admissions settings and in handling of Medical Records
• Provide excellent customer service at all times by effectively meeting customer needs, understanding who the customers are, and building quality relationships
• Answer telephone in a professional and courteous manner, record messages and communicate to appropriate medical staff
• Provide and obtain signatures on required forms and consents
• Obtain, verify, and enter complete and accurate demographic information on all accounts to facilitate smooth processing through the revenue cycle
• Verify insurance benefits for all plans associated with patient, confirming the correct payor and plan is entered into the patient accounting system
• Obtain insurance authorizations as required by individual insurance plans where applicable
• Maximize the efficiency and accuracy of the collection process by pursuing collections at the time of service in a customer service-oriented fashion
• Scan all registration and clinical documentation into the system and maintain all medical records
• Assist with coordinating the transfer of patients to other hospitals when necessary
• Respond to medical record requests from patients, physicians and hospitals
• Maintain cash drawer according to policies
• Maintain log of all patients, payments received, transfers and hospital admissions
• Maintain visitor/vendor log
• Distribute mail appropriately
• Assist with compiling, analyzing, and reporting data for Patient Access quality measures
• Ensure QA on patient registrations, admissions and transfers
• Ensure QA of site-specific medical records storage and upkeep
• Assist in ordering office supplies, dietary and employee snacks where applicable
• Assist with management of worklists/workqueues within the patient accounting system
• Serve as first line of contact for PAS when on duty
• Assist with training of new employees in all aspects of their assigned job
• Work alongside Patient Access team members to ensure processes and policies are being followed

Other Job Functions

• Maintain a clean working environment for the facility. This includes the front desk, restroom, waiting room, break area and patient rooms when assistance is needed by medical staff
• Receive deliveries including mail from various carriers and forward to appropriate departments as needed
• Notify appropriate contact of any malfunctioning equipment or maintenance needs
• Attend staff meetings or other company sponsored or mandated meetings as required
• Assist medical staff as needed
• Perform additional duties as assigned

Basic Qualifications

• High School Diploma or GED, required
• 3 years patient registration and insurance verification experience in a health care setting, required.
• Emergency Department experience strongly preferred.
• Knowledge of various insurance plans (HMO, PPO, POS, Medicare, Medicaid) and payors, required.
• Basic understanding of medical terminology
• Excellent customer service
• Working knowledge of MS Office (MS Word, Excel and Outlook), strongly preferred.
• Position requires fluency in English; written and oral communication