Patient Access Specialist, Outpatient Infusion

North Mississippi Health Services; Tupelo (MS); Vor Ort; USD 32.000 - 45.000; Vollzeit

Zusammenfassung

North Mississippi Health Services is seeking a Patient Access Specialist to support the organization’s financial health by handling demographic and insurance information, point of service collections, and financial arrangements, with direct patient contact.

The role requires strong analytical, organizational, and communication skills, HIPAA compliance, and the ability to resolve real-time edits and denials while coordinating with internal and external stakeholders to ensure timely patient flow

Qualifikationen

• Experience handling Demographic and Insurance Information.
• Excellent analytical and organizational skills.
• Strong communication with patients and staff.

Aufgaben

• Schedule and pre-register patients for appointments and procedures.
• Verify demographics, insurance eligibility, and benefits.
• Provide test preparation instructions and appointment details.
• Explain estimates and payment options to patients.
• Ensure HIPAA guidelines are enforced during registration.

Kenntnisse

Analytical skills

Organizational skills

Communication skills

Jobbeschreibung

Posting Description

We believe a career is more than just a career — it's a calling. Our teammates' \"True North\" is what calls them to health care; it’s their passion. At North Mississippi Health Services, we believe in helping you leverage and connect that passion with a much greater purpose that impacts people you know and love.

Job Summary

The Patient Access Specialist at North Mississippi Health Services is responsible for supporting the overall financial health of the organization by completing the daily activities of the collecting and input of Insurance Information, Point of Service Collections and Financial Arrangements, & Customer Service via Direct Contact with Patients and their family members. This role operates under the guidance of the Patient Access Manager and requires an experienced individual with excellent analytical, organizational, and communications skills to manage Demographic and Insurance Information. resolve real time edits & denials, and interface effectively wit h internal and externa l stakeholders to promote timely and accurate patient flow and collections.

Scheduling

JOB FUNCTIONS

• Responsible for scheduling/rescheduling, pre-certifying, checking medical necessity, and pre-registering patients for appointments, diagnostic tests, and outpatient procedures as ordered by referring providers
• Obtains necessary information required for scheduling, pre-certification, and pre-registration
• Obtains and/or verifies patient demographics, insurance information/eligibility, and benefits
• Responsible for informing patients and/or clinical staff of the proper preparation and instructions for the tests ordered
• Notifies patient of the location of the appointment date & time, test, and/or procedure

Patient Experience

• Obtains crucial confidential patient identification information including patient records, signatures, and payment information repeatedly and ensures HIPAA guidelines are enforced
• Effectively communicates NMHS’ organizational revenue cycle and financial policies including estimates, charity plans and payment options to patients and patient representatives
• Provides bedside registration to obtain consent form signatures, collect insurance, and other confidential information pertinent information to ensure accurate medical record data entry that aligns with CMS and other regulatory agencies

Collections & Financial Arrangements

• Ensures team members are providing estimates to guarantors for elective procedures and collection attempted at the point of pre-registration or point of service
• Ensures team members are administering ABNs when necessary
• Ensures accounts are financially secure prior to service
• Ensures timely and accurate processing of accounts in accordance with best practices, defined workflow, procedures, and applicable legislation/regulations

Denials Management

• Corrects front end errors real time to minimize denial throughput
• Develops strategy for consistently obtaining accurate, timely, and beneficial patient demographic information
• Review post service denials to assist in developing front end strategies to reduce denial inflow
• Identifies trends and reports potential significant and recurring issues along with possible solutions to leadership
• Takes proactive, corrective action through systematic and procedural development to reduce incoming denials

Contract Management

• Maintains familiarity with payer methodologies to ensure accurate estimates are communicated with patients & system variances are communicated with leadership
• Manages expected reimbursement to ensure appropriate patient portion is collected prior to service
• Develops strategy for partnering with business office to ensure estimates & transparency is accurate
• Analyzes estimate variances to understand where/why deviations occurred
• Identifies trends and reports potential significant and recurring issues along with possible solutions to leadership