Patient Access Specialist I

Bayhealth; Milford (DE); On-site; USD 24,000 - 36,000; Full time

Benefits offered by this job

Paid time off

403(b) matching

Health, dental, and vision insurance

Disability and life insurance

On-site child care

Educational reimbursement

Health care and dependent care FSAs

Voluntary benefits

Job summary

Bayhealth Medical Center in Sussex Campus is seeking a Patient Access Specialist I. This entry-level role performs complete registration and admissions functions under supervision to support care continuity and revenue cycle efficiency.

A minimum of one year in a customer service role is required. The position offers day/evening shifts, full-time hours, and a hourly pay range of 17.40–26.10 with a comprehensive benefits package as listed.

Qualifications

• One year of experience in a customer service role.
• High School Diploma or GED required.

Responsibilities

• Provide customer service by communicating clearly and respectfully to obtain necessary information.
• Complete registration and admissions functions accurately for continuity of care and revenue cycle efficiency.
• Verify demographic and insurance information; use payer websites or URLs for verification; obtain insurance cards and IDs.
• Enter data for procedures and diagnoses; assess medical necessity and follow pre-established guidelines.
• Obtain and verify physician orders for tests and procedures to minimize reimbursement risk.
• Ensure required authorizations are obtained prior to service and address issues with supervision as needed.
• Perform point-of-service collections and discuss co-pays, deductibles, and balances with patients.
• Maintain accurate documentation in the EHR and balance cash draw according to procedures.

Education

High School Diploma or GED

Job description

If you care about the opportunity to grow, to make a difference, to build a future and a life, then we just might have the career for you. Care to talk?

Bayhealth Medical Center is Central and Southern Delaware’s healthcare leader with hospitals in Dover and Milford, as well as stand‑alone Emergency Department in Smyrna and a hybrid Emergency Department and Urgent Care in Milton. We offer various practice settings throughout Kent and Sussex Counties. Bayhealth Medical Center Kent Campus is 90 minutes from Philadelphia, Washington, DC and Baltimore. Our Sussex Campus is 30 minutes to the Delaware beaches and relaxation in the sand!

Bayhealth Medical Center offers a competitive salary and comprehensive benefits package (for eligible positions) including:

• Generous Paid Time Off and Paid Holidays
• Matching 401(k)/403(b) Plans
• Excellent Health, Dental, and Vision
• Disability and Life Insurance options
• On Site Child Care
• Educational Reimbursement
• Health Care and Dependent Care Flex Spending Accounts
• Plus, an array of Voluntary Benefits to include Critical Care Coverage and more!

Location: Sussex Campus Hospital

Status: Full Time 80 Hours

Shift: Day/ Evening

SALARY RANGE: 17.40 - 26.10 HOURLY

General Summary

Under the supervision of the Patient Access, Supervisor and Team Lead, the Patient Access Specialist I (PAS I) performs complete and accurate registration and admissions functions to provide information for continuity of care and revenue cycle efficiency. The PAS I is an entry level position with the responsibility to obtain and verify demographic, insurance, and eligibility information during the registration process including point of service payments. Provides payment estimates for out-of-pocket costs. In this role the PAS I is assigned to one department/location.

The PAS I must demonstrate competence in each essential duty to become eligible for the PAS II position. A minimum of one-year patient registration experience in the assigned department is required for consideration for PAS II.

Responsibilities

• Customer Service; meets the needs of the patient/ patient representative by using clear and respectful communication while obtaining necessary information.
• Timely and precise completion of each registration, following all department processes and procedures. Must verify that all demographic and insurance information is accurate; utilizes Epic, payer websites or telephone for insurance verification. Obtain current copies of insurance cards and photo identification. Secures patient signatures for required forms.
• Enter data related to procedures, tests, and diagnoses (when applicable). Determines the need for medical necessity and follows the advanced beneficiary notice process when appropriate based on pre-established guidelines.
• Obtains and verify the accuracy of physician orders for tests and procedures to minimize risk to hospital reimbursement.
• Identify the patient using two factor identification. Complies with EMTALA regulation when creating the quick registration account (when applicable).
• Ensure authorizations (pre-certifications, prior authorization, referrals) are obtained prior to service, as applicable. Notify supervisor of any insurance authorization issues.
• As appropriate, completes Medicare Secondary Payer questionnaire without errors to support compliance with CMS policies.
• Perform point of service collections: Responsible for meeting monthly collection goals, having financial conversations with patients as it relates to their co-payments, deductibles, co‑insurance, deposit amounts and outstanding balances. Documents payments/actions in the EHR and provides the patient with a payment estimate (when applicable). Follows cash drawer balancing procedures, as appropriate, reconciles payments against deposit totals.
• Review and resolve account errors in assigned work queues.
• Maintain qualitative and quantitative individual and team performance targets.
• Responds to disaster and mass casualty situations in a calm and appropriate fashion. Maintains and understands the emergency management processes and procedures specific to that unit.
• Adheres to department and system policies. Interact with co‑workers, visitors, and other staff consistent with the Bayhealth values.
• Scheduling (as applicable) – may need to schedule appointments, following procedures and protocols. Assist patients with referral needs in obtaining additional appointments with specialists, and insurance approval authorization for additional visits.
• Patient flow (as applicable) - maintain efficient patient flow in the registration and check‑in process. Accurately complete reception duties in accordance with policies.
• All other duties as assigned within the scope and range of job responsibilities.

Required Education, Credential(s) and Experience

• Education: High School Diploma or GED ;
• Credential(s): None Required
• Experience: Required: One (1) year in a customer service role.

Preferred

Experience in healthcare or medical office environment. Knowledge of medical terminology.

Preferred Education, Credential(s) and Experience

• Education: Associate Degree Associate Degree Business Administration Related field
• Credential(s):
• Experience:

To view a full list of all open position at Bayhealth, please visit: https://apply.bayhealth.org/join/