Specialist-Patient Access

North Mississippi Health Services; Winfield (AL); On-site; USD 24,797,000 - 38,573,000; Full time

Job summary

North Mississippi Health Services is seeking a Patient Access Specialist to support the revenue cycle by handling scheduling, pre-registration, and patient data capture. The role involves communicating with patients and staff to collect demographics and insurance information and ensure accurate data entry for CMS compliance.

Under the guidance of the Patient Access Manager, you will resolve real-time edits and support timely patient flow, with emphasis on analytical, organizational, and

Qualifications

• Strong analytical, organizational, and communication skills.
• Ability to handle sensitive patient information and follow HIPAA guidelines.

Responsibilities

• Scheduling/rescheduling, pre-certifying, checking medical necessity, and pre-registering patients for appointments, tests, and procedures.
• Obtains necessary information for scheduling, pre-certification, and pre-registration.
• Verifies patient demographics, insurance information/eligibility, and benefits.
• Informs patients and staff of preparation and instructions for tests ordered.
• Notifies patients of appointment location, date, and time.
• Maintains confidential patient data and ensures HIPAA compliance.
• Explains estimates, charity plans, and payment options to patients and representatives.
• Ensures accurate medical records and CMS-aligned data entry.

Skills

Analytical skills

Organizational skills

Communication skills

HIPAA compliance

Job description

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