Patient Access Account Specialist

Presbyterian Healthcare Services; Albuquerque (NM); On-site; USD 222,317 - 3,522,523; Full time

Benefits offered by this job

Medical, dental, vision coverage

Disability insurance

Life insurance

Wellness program

Job summary

Presbyterian Healthcare Services in Albuquerque, NM is seeking a Patient Access Account Specialist I to ensure financial clearance before service. You will verify insurance, obtain authorizations, and collect patient data for accurate billing.

The role requires a high school diploma, EPIC ADT proficiency, and 2+ years in healthcare access/billing. CHAA/CHAM credentials are a plus and compliance with CMS/HIPAA is essential.

Qualifications

• High school diploma; continued education preferred.
• Pass Patient Academy with a score of 85% or higher.
• Complete and pass Patient Access Advocate II and III tests.
• At least 2 years of healthcare experience in Patient Access or billing.
• Strong knowledge of insurance and financial processing of accounts.
• Proficient in EPIC ADT system.
• Certifications: CHAA or CHAM preferred.
• Pass annual competency exam for all responsibilities.

Responsibilities

• Ensure accounts are financially cleared prior to service date.
• Perform patient registration and collect/verify data for final clearance.
• Enter demographic and financial information needed for clearance.
• Review urgent/admission accounts for clearance and authorization pre-discharge.
• Obtain missing insurance details including policy and group numbers.
• Verify eligibility and benefits with payers or via online verification.

Skills

Customer service

Attention to detail

Communication

Education

High school diploma

Tools

EPIC ADT

Job description

Location Address:

1100 Central Ave SEAlbuquerque, NM 87106-4930

Compensation Pay Range:

Minimum Offer $16.38 Maximum Offer $25.57

Now Hiring: Patient Access Account Specialist

Summary:

Build your Career. Make a Difference. Presbyterian is hiring a skilled Patient Access Account Specialist I.

The Patient Access Account Specialist I provides basic functions to financial clear patient accounts for government and commercial accounts prior to the date of service. Performs basic financial clearance functions, including insurance verification, authorization, collection and documentation of patient demographics, benefit analysis, and pre-service collections. The Patient Access Account Specialist I will ensure follow up on authorizations for scheduled and Urgent/Emergent procedures and admissions until date of service or discharge for admissions. The Patient Access Account Specialist I must possess a basic knowledge of Medicare (CMS) guidelines, as well as other Compliance Regulatory guidelines applicable to Patient Access to include HIPAA, EMTALA, and CMS guidelines of MSPQ. The Patient Access Account Specialist (PAAS I) monitors work queues for financial clearance and missing authorizations ensuring a payment source is identified and secured and there is a clean claim for billing.

Type of Opportunity: Full timeJob Exempt: NoJob is based: Presbyterian HospitalWork Shift: Days (United States of America)

Responsibilities:

Customer Service and Caring Practices:

• Ensures accounts are financially cleared prior to date of service to alleviate patient concerns over hospital financial matters

• Performs the patient registration process. Manage the accurate collection of patient data which includes but is not limited to;

• Obtain/confirm and enter demographic and other financial and clinical information necessary for final clearance of scheduled accounts.

• Review Urgent/Emergent admission accounts for notification, financial clearance and authorization pre-discharge.

• Obtain missing insurance information, to include policy number, group number, date of birth, and insurance phone number if not already identified in account.

• Verify insurance for eligibility and benefits using online electronic verification system or by contacting payer directly.

Financial Accountabilities:

• Collects identified patient financial obligation amounts including residual balance if applicable. Collect liability from patient prior to visit or make arrangements for payment at time of service.

• Ensure a payer source has been identified prior to services being rendered.

• Ensure authorization for correct procedure (CPT), facility, and date of service is obtained.

Qualifications:

• High school diploma, continued education preferred

• External and Internal Non-Patient Access Candidates: Pass Patient Academy with passing score of 85% or higher

• Previous completion and passing of Patient Access Advocate II and III Advancement test.

• A minimum of 2 years of work experiences in healthcare setting within Patient Access and/or billing plus strong customer service background.

• Strong knowledge and understanding of insurance and financial processing of accounts.

• Proficient in EPIC ADT system

• Specialty Certifications: CHAA, CHAM or other industry equivalent certification preferred

• Pass annual competency exam for all areas of responsibility

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness

Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?

As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services