Patient Access Specialist - PreCertification

St. Tammany Health System; Madisonville (LA); Sur place; USD 21 000 - 30 000; Plein temps

Résumé du poste

St. Tammany Health System seeks a Patient Access Specialist to manage registration, check-in/out, scheduling, and insurance initiation for inpatients and outpatients. You will verify coverage, obtain authorizations, and communicate effectively with patients and providers.

Hours are 40 per week, Monday through Friday, 8:30 am to 5:00 pm. The role emphasizes patient confidentiality, accuracy of information, and contributing to throughput and revenue cycle goals.

Qualifications

• Customer service experience in a medical/office setting.
• Ability to verify insurance and obtain authorizations.
• Strong communication with patients, staff and insurers.

Responsabilités

• Handle registration, check-in/check-out, and scheduling of appointments.
• Verify insurance coverage, benefits and determine payer liability.
• Enter orders, review medical necessity, and assist with financial counseling.
• Mentor other Patient Access staff and support HIPAA compliance.

Connaissances

Customer service

Scheduling

Insurance verification

HIPAA compliance

Communication skills

Training abilities

Formation

High school diploma

Some college preferred

Outils

HIS systems

Description du poste

At St. Tammany Health System, delivering world-class healthcare close to home is our goal. That means we are committed to attracting and retaining the very best professionals for every position in our health system.

We believe the pristine beauty of St. Tammany Parish adds to our attractive compensation package. The health system is nestled in the heart of Covington on the north shore of Lake Pontchartrain. It is a peaceful, scenic, community-oriented area with an abundance of amenities to suit every taste.

Job Description And Position Requirements

Scheduled Weekly Hours: 40

Hours: Mon - Fri, 8:30 am - 5:00 pm

Summary of the Job:

The Patient Access Specialist is responsible for completing efficient and organized processes in the areas of registration, check-in/check-out, admission, insurance initiation and verification and benefit research for inpatients/outpatients and scheduling of appointments. Excellent customer service skills are crucial in these roles as well as flexibility in work shifts. The Patient Access Specialist must ensure that accurate information is collected, that they are always sensitive to the confidentiality of this information, and that patients are aware of their rights as determined by HIPAA regulations and company policy, and that they are a consistent proponent of patient throughput and volume growth.

The Patient Access Specialist responsibilities include duties such as verifying insurance coverage, benefits, obtaining and initiating authorizations, completing registration pathways in the HIS systems, receiving, maintaining, clarifying, entering and/or validating physician orders, scheduling appointments, determining third party payer liability for organizational billing, checking medical necessity, handling daily batching and posting of point of service payments and having conversations with patients to resolve previous and current balances. Maintains a positive relationship with healthcare team and is a resource to physicians, staff and patients for information regarding orders, insurance and referrals, as well as any other issues that might impact the relationship/experience of these stakeholders .The Specialist is also responsible for training and mentoring other Patient Access Representatives and Specialists in the more technical aspects of job.

Minimum Qualifications

High school diploma or equivalent. Some college preferred. At least 1 year of previous customer service experience in an office / medical office environment including scheduling, admitting, and/or financial counseling.

Preferred Qualifications

Excellent written and verbal communication skills demonstrating the ability to communicate effectively and courteously with physician office staff, patients, and/or insurance carriers. Ability to work in a fast-paced professional environment. Demonstrated competency to successfully perform Patient Access Representative duties, which would typically be obtained through 12 months direct experience. Ability to understand and solve complex problems dealing with governmental entitlement programs, commercial insurance requirements, contractual obligations, and reporting requirements. Ability to apply the use and terminology associated with CPT and ICD-10 coding, as well as basic anatomy/physiology, and out-patient diagnostic testing medical terminology, Medicare guidelines, HMO and PPO contracts and other insurance billing processes. Excellent organizational skills and maintains a professional and neat work environment.

Please note – some of these positions are essential personnel during disaster situations (like Hurricane evacuations/threats). These essential positions include ER Patient Access Specialists and some Lead level positions. Please inquire during the hiring process to ensure you are aware of the requirement for your position. Depending on location, process and system knowledge will differ. Examples include order entry at the outpatient locations and scheduling in some satellite locations.

While not required, education or certifications in the following areas are helpful in acquiring a position in the area - as well as for advancement opportunities:

• Certified Healthcare Access Associate (CHAA) through the National Association of Healthcare Access Management (NAHAM)
• Completion of a medical terminology course.
• Bilingual - preferably Spanish.

Physical Demands

Must possess good physical health. Some requirements include but are not limited to standing, sitting or walking for long periods of time. Lifting at least 20 pounds is required. Must be able to work with a moderate level of noise.

Physical Effort required

Constant (67%-100%) - handling/feeling, talking, hearing, seeing

Frequently (34%-66%) – reaching

Occasionally (1%-33%) - lifting, carrying, pushing/pulling, climbing (stairs, ladders, etc.), balancing, stooping, crouching

EMPLOYMENT

Each St. Tammany Health System staff member is expected to conduct himself or herself according to our mission, vision and values. Please take time to review those expectations, which can be found by clicking here, before applying for employment. If you feel you are unable to demonstrate those characteristics, we respectfully request that you do not proceed with the application process.

EQUAL OPPORTUNITY EMPLOYER

St. Tammany Health System is an Equal Opportunity Employer. St. Tammany Health System is committed to equal employment opportunity for all employees and applicants without regard to race, color, religion, sex, age, national origin or ancestry, citizenship, sexual orientation, gender identity, veteran status, disability status, genetic information or any other protected characteristic under applicable law.