Specialist-Patient Access

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.

JOB FUNCTIONS
Scheduling:
•  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 are 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



QUALIFICATIONS


Education

• Bachelor's Degree In Business, Healthcare, Coding, or equivalent field. Required
• Associate's Degree Willing to consider 4 years Patient Access, Claims, Billing/ Follow-Up, or revenue cycle experience beyond minimum requirement in lieu of Bachelor degree. Required
• High School Diploma or GED Equivalent Willing to consider 8 years Patient Access, Claims, Billing/ Follow-Up, or revenue cycle experience beyond minimum requirement in lieu of Bachelor degree. Required
  
  Licenses and Certifications
  
  
  Work Experience
  
• 1-3 years
• 1-3 years
  
  Knowledge Skills and Abilities
  
• Working knowledge of Registration systems, Medicare/Medicaid/Third Party Liability/Workers Compensation
• Proficient in Microsoft Office (Word, Excel, and Outlook)
• Knowledge of applicable state and federal regulations relating to registering accounts and collecting at point of service
• Excellent negotiating and analytical skills
• Strong verbal and written communication skills
• Excellent interpersonal skills
• Effectively and efficiently prioritizes and organizes tasks
• Develops, implements/evaluates projects (timely & efficient manner)
• Ensures accurate and timely collection of all appropriate patient estimates
• Ensures effective monetary management of Deposits
• Ensures timely and accurate processing of accounts in accordance with best practices, defined workflow, procedures, and applicable legislature/ regulations
• Gathers and relays information with knowledge, tact, and diplomacy
• Experiences daily contact with co-workers, patients, payers, and other NMHS/NMMC staff members
• Exhibits strong written and verbal communication skills
• Reflects a positive, caring attitude toward clients, patients, staff, and the public we serve
• Evaluates and coaches reporting employees to accomplish major goals and objectives
• Develops, implements/evaluates projects in a timely & efficient manner
• Effectively communicates information to staff, internal and external customers
  
  Physical Demands
  
  A thorough completion of this section is needed for compliance with legal standards such as the Americans with Disabilities Act. The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
• Standing . Constantly
• Walking . Frequently
• Sitting . Rarely
• Lifting/Carrying . Frequently 50 lbs
• Pushing/Pulling . Frequently
• Climbing . Occassionally
• Balancing . Occassionally
• Stooping/Kneeling/Bending . Frequently
• Reaching/Over Head Work . Frequently
• Grasping . Frequently
• Speaking . Occassionally
• Hearing . Constantly
• Repetitive Motions . Constantly
• Eye/Hand/Foot Coordinations . Frequently
  
  Benefits A****vailable
• Continuing Education
• 403B Retirement Plan with Employer Match Contributions
• Pet, Identity Theft and Legal Services Insurance
• Wellness Programs and Incentives
• Referral Bonuses
• Employee Assistance Program
• Medical Benefits
• Dental Benefits
• Vision Benefits
• License + Certification Reimbursement
• Life, Long-Term and Short-Term Disability, Group Accident, Critical Illness and Hospital Indemnity Insurance
• Employee Discount Program
• Other:
• Early Access to Earned Wages
• Tuition Assistance
• Relocation Assistance
• Paid Time Away
• Special Employee Rates at NMMC Wellness Centers