Patient Access Representative II - Lift Wellness Center

West Tennessee Healthcare; Jackson (TN); On-site; USD 36,000 - 52,000; Full time

Job summary

West Tennessee Healthcare in Jackson, TN seeks a Patient Access Services specialist to mentor staff and enhance department operations within the Revenue Cycle.

The role focuses on completing the financial clearance process, coordinating information from patients and providers to schedule appointments, and creating a positive initial impression of WTH’s services for patients and families.

Qualifications

• High School diploma or equivalent required.
• 2-3 years health care or related experience required.
• Strong communication and organizational skills are essential.
• Demonstrated knowledge of healthcare reimbursement and patient access procedures.

Responsibilities

• Ensures proper insurance payer plan choice and billing address in the automated system.
• Contacts payers to verify insurance eligibility for Financial Clearance.
• Refer to designated area if medical necessity fails or referrals/authorizations are denied.
• Interpret third-party payer policies to establish patient financial liabilities and assist patients with understanding their responsibilities.
• Collect co-pays, co-insurance, and deductibles according to policies.
• Advises leadership of postponement/deferral of elective admissions when not approved.
• Maintains accurate pre-processing files as required.
• Demonstrates strong communication with staff to resolve urgent issues promptly.
• Investigates and documents patient problems and coordinates with medical staff as needed.
• Cross-train within Patient Access Services and perform related responsibilities.

Skills

Financial Clearance

Scheduling

Registration

ED Registration

Patient Access

Data entry

Education

High School Graduate

Tools

Revenue Cycle software

Windows-based applications

Word processing

Spreadsheets

Job description

Category:

Admin Support

City:

Jackson

State:

Tennessee

Shift:

8 - Day (United States of America)

Job Description Summary:

This position will function as a subject matter expert for the department and will help coach and mentor less experienced staff on all aspects of Patient Access Services and the Revenue Cycle. This position is responsible for completing the financial clearance process within PAS and creating the first impression of WTH’s services to patients and families and other external customers. Responsible for obtaining, coordination, and directing information from patients, physician offices, hospital departments, and clinics in order to schedule patient appointments. PAS reps may also be responsible for scheduling patients.

ESSENTIAL JOB FUNCTIONS:

• Ensures that proper insurance payer plan choice and billing address are assigned in the automated patient accounting system.
• Financial Clearance - Contacts payers to verify insurance eligibility.
• Refers to the designated area if medical necessity fails or if referrals /authorizations are denied.
• Pre-Service/ Point of Service Collection - Interprets third-party payer policies to establish patient financial liabilities and work with patients so they understand their patient financial responsibilities.
• Collect co-payments,co-insurance,and deductibles according to pre-service/ point of service collections policies and procedures.
• Communication & Miscellaneous - Advises next-level leader of possible postponement or deferrals of any elective/non-emergent admission which has not been approved prior to service date.
• Maintains accurate files for pre-processing information as required.
• Demonstrates excellent communication skills and the ability to work with all levels of staff to resolve urgent issues in a prompt and professional manner.
• Investigates,resolves,and documents patient problems and contact medical staff,nursing staff,ancillary departments,and administration as necessary.
• Assists with cross training function in areas within Patient Access Services.
• Performs related responsibilities as required or directed.

JOB SPECIFICATIONS:

EDUCATION:

• High School Graduate, or equivalent

LICENSURE, REGISTRATION, CERTIFICATION:

• N/A

EXPERIENCE:

• 2-3 years of health care or related experience required

KNOWLEDGE, SKILLS, AND ABILITIES:

• Demonstrate proficiency and ability performing the following functions: Financial Clearance, Financial Counseling, Scheduling, Registration, ED Registration, and Patient Access.
• Understanding of healthcare business and finance principles with special emphasis on hospital and physician access services.
• Demonstrated knowledge of healthcare management, registration, billing, and collection processes for government, grant, and non-government funding sources.
• Demonstrated detailed working knowledge of Patient Access procedures and healthcare reimbursement to include familiarity with various payer mixes.
• Comfort with data entry within Revenue Cycle software, patient management systems and Windows-based applications preferred.
• Strong experience with patient accounting systems and knowledge of word processing and spreadsheet applications.
• Strong interpersonal skills and the ability to work through a variety of issues in a diplomatic fashion required.

NONDISCRIMINATION NOTICE STATEMENT

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, disability, religion, national origin, gender, gender identity, gender expression, marital status, sexual orientation, age, protected veteran status, or any other characteristic protected by law.