Patient Access Specialist Sr

INTEGRIS Health; Yukon (OK); On-site; USD 25,000 - 33,000; Full time

Job summary

INTEGRIS Health Canadian Valley Hospital in Yukon, OK is hiring a full-time Patient Access Specialist Sr. to support ancillary, diagnostic, surgical and emergency services.

The role acts as a liaison with patients, providers and payers to resolve pre-care matters and explain coverage, benefits, and financial liability. The position requires strong customer service, communication and analytical skills, with 4 years of patient access experience and preferred healthcare certifications.

Qualifications

• 4 years of Patient Access operations activities (scheduling/registration/insurance) or related experience
• Experience in scheduling, registration, insurance, billing, collections, and customer service in hospital or physician office

Responsibilities

• Ensures the accuracy of complex registration activity including scheduling and demographic verification
• Verifies coverage eligibility, insurance verification, patient portion calculation and authorization activity
• Uses analytical thinking and judgment to adjust service area schedules and handle special requests
• Answers inbound calls from patients, providers, and payers to resolve concerns
• Collects patient payments and ensures financial clearance
• Documents all patient accounts activities and required authorizations
• Performs filing, data entry and other duties as assigned
• Responds to inquiries about pre-care services, policies, coverage and liability
• Resolves patient or payor inquiries using multiple resources and systems
• Ensures EMTALA and HIPAA compliance and acts as a systems expert for patient access

Skills

Customer service

Communication

Analytical thinking

Problem solving

Education

Bachelor's degree in related field

Healthcare Certification (AAHAM CRCS, HFMA CRCR, NAHAM CHAA)

Tools

Microsoft Office

Billing software

EMR/EHR systems

Job description

Job Description

Join our team as a full time (Sun - Thurs 7am to 3pm), Patient Access Specialist Sr at INTEGRIS Health Canadian Valley Hospital in Yukon, OK.

Get to Know Your Team

• INTEGRIS Health, Oklahoma’s largest not-for-profit health system, is seeking a dedicated caregiver to join us in our mission to partner with people to live healthier lives.
• Benefits of being an INTEGRIS Health caregiver include front-loaded PTO, medical benefits through the extensive INTEGRIS Health network, financial assistance for continued education, 24/7 mental health support and more.
• Take the first step toward growing your career by joining us.

Responsibilities

The Patient Access Specialist Sr. is responsible for the provision of patient access activity for ancillary, diagnostic, surgical and emergency services as assigned to facilitate efficient operations, expeditious reimbursement and optimal customer satisfaction and employee satisfaction. Acts as a liaison between INTEGRIS and patients, providers, and payers for all pre-care matters related to account resolution. Provides information regarding the patient's coverage eligibility and benefits, patient's financial liability, INTEGRIS Health's billing practices and policies.

• Ensures the appropriateness of complex registration activity including scheduling, verifying patient demographic information, processing point of service payments, obtaining signatures for required consent paperwork, document imaging and following documentation standards to facilitate efficient patient access according to assigned protocol
• Ensures the appropriateness of complex patient access transactions including coverage eligibility, insurance verification, patient portion calculation and authorization requirement activity utilizing available systems and resources according to assigned protocol.
• Possesses the ability to use analytical thinking, independent judgment, and clinical knowledge to adjust service area schedules and accommodate special requests from internal and external customers.
• Accepts inbound phone calls from patients, physician offices, insurance carriers, etc. with the intent to resolve the concern immediately.
• Collects patient payments and follows levels of authority to ensure financial clearance.
• Documents all patient accounts activities concisely, including authorization and patient liability requirements.
• Performs filing, data entry, and other duties as assigned.
• Responds promptly to patient inquiries regarding pre-care services, policies, coverage, benefits and financial liability.
• Utilizes multiple resources to resolve patient or payor inquiries while on the phone or preparing/reviewing patient accounts or prior authorization requirements.
• Understands different payer regulations and can communicate effectively with patients regarding their coverage benefits and financial liability.
• Acts as a liaison to resolve complex patient access and account issues, responds to questions on reimbursement and serves as a resource and systems expert for patient access specialists, including on-the-job training, and for performance improvement and appropriateness of complex patient access transactions.
• Provides guidance, feedback and training to staff on multiple processes, payers and systems, and monitors assignments and assess productivity.
• Handles all communication effectively, including telephone, email, and verbally with all departments and caregivers within the health system.
• Initiates and coordinates the implementation of team-oriented process improvement initiatives for the department and organization.
• Initiates and coordinates continuous quality improvement efforts, establishes goals with supervisors, tracks progress, and prepares data for presentation.
• Interprets and maintains compliance with performance standards, federal and state regulations including EMTALA and HIPAA, policies, procedures, guidelines, and third-party contracts.

Qualifications

• 4 years of Patient Access operations activities (scheduling/registration/insurance) or related experience (billing, collections, accounts receivables)
• Previous experience in one of the following: scheduling, registration, insurance, billing, collections, and customer service in either a hospital or physician's office setting

Preferred Job Qualifications

• Bachelor's degree in related field or Healthcare Certification (AAHAM CRCS, HFMA CRCR, NAHAM CHAA) preferred
• Previous experience with Microsoft Office programs and experience with admission/discharge/transfer or billing/claims management software
• Previous experience with medical terminology, basic ICD 10 and CPT coding healthcare program reimbursement and methodologies
• Previous experience in 3+ of the following: scheduling, registration, insurance (including Medicare, Medicaid, and third-party regulations), billing, collections, and customer service in either a hospital or physician's office setting

INTEGRIS is an Equal Opportunity/Affirmative Action Employer. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.

About Us

• INTEGRIS Health, Oklahoma’s largest not-for-profit health system, is seeking a dedicated caregiver to join us in our mission to partner with people to live healthier lives.
• Benefits of being an INTEGRIS Health caregiver include front-loaded PTO, medical benefits through the extensive INTEGRIS Health network, financial assistance for continued education, 24/7 mental health support and more.
• Take the first step toward growing your career by joining us.