Patient Access Rep.

GA_SMHHS20 St. Mary's Sacred Heart Hospital, Inc.; Lavonia (GA); On-site; USD 40,000 - 55,000; Full time

Job summary

Trinity Health is seeking a Patient Access Account Specialist to support outpatient and inpatient registration, verify insurance, and collect patient payments. You will help ensure eligibility and compliance while delivering compassionate, patient-centered service.

As part of the Patient Access team, you will use multiple system applications to perform data entry, generate reports, and explain benefits. Prior hospital registration or insurance verification experience is preferred; HFMA CRCR or

Qualifications

• Minimum one year of customer service experience.
• Two years hospital registration or insurance verification experience preferred.

Responsibilities

• Provides patient focused customer service.
• Performs outpatient and inpatient registration and insurance verification.
• Collects patient financial liability payments and ensures financial requirements are met.
• Explains insurance benefits to patients and families.
• Supports distribution of analytical reports and performance improvement initiatives.

Skills

Customer service

Insurance verification

Explain benefits

Medical terminology

Coding knowledge

Education

High school diploma or equivalent

Job description

Employment Type: Full time Shift: Description: Provides patient focused customer service. Performs outpatient & / or inpatient registration & insurance verification functions; collects patient financial liability payments & ensures that patients meet financial requirements including Medicare medical necessity, payer pre-certifications & referrals. Provides general information to hospital users, patients, families & physician offices. Note: “patients” refers to patients, clients, residents, participants, customers, members

Our Trinity Health Culture:

Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions.

Work Focus:

Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience. Responsible for distribution of analytical reports.

Process Focus:

Utilizes multiple system applications to perform analysis, create reports & develop educational materials. Incorporates basic knowledge of Trinity Health policies, practices & processes to ensure quality, confidentiality & safety are prioritized. Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge.

Data Management & Analysis:

Research & compile information to support ad-hoc operational projects & initiatives. Synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions while considering the impact on business strategy & supporting leadership decision making. Leverages program & operational data & measurements to define & demonstrate progress, ROI & impacts. Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices.

Functional Role (not inclusive of titles or advancement career progression)

PAR I Entry level position. Minimum one (1) year customer service experience. Patient Access experience preferred.

PAR II Performs PAR I role & is cross trained & performs activities in Pre-Service, Emergency Department & / or Bed Desk. Additional minimum qualifications: Minimum of two (2) years hospital registration or insurance verification experience upon hire. Knowledge of medical terminology, diagnostic coding & procedural coding required. Ability to explain insurance benefits.

Patient Access Account Specialist Additional minimum qualification of two plus (2+) years hospital registration or insurance verification experience. Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization’s strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge. Responsible for analyzing, processing & editing for correctness based on payer guidelines. Resolves items & ensures claims are billed accurately. Processes payments timely.

Minimum Qualifications High school diploma or equivalent. HFMA CRCR or NAHAM CHAA required within one (1) year of hire.

Additional Qualifications (nice to have) Medical terminology required & knowledge of diagnostic & procedural coding Insurance verification with the ability to explain benefits, secure necessary authorization

Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care.

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. Together, we’re 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, our system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations, and many other health and well-being services. Based in Livonia, Michigan, in fiscal year 2023, we invested $1.5 billion in our communities through charity care and other community benefit programs. For more information, visit http://www.trinity-health.org. You can also follow Trinity Health on LinkedIn.