Patient Access Specialist

Spartanburg Regional Healthcare System

Job Description

Position Summary

The Patient Access Specialist position receives, coordinates and implements the initial patient experience by providing critical functions essential to ensuring proper clinical treatment, billing and reimbursement, patient satisfaction as well as efficient and accurate handling of the patient registration process.
Assists with Onboarding of new associates
Cross training of current associates
Comprehensive Pre-Registration process for specified departments/modalities due to sensitive nature of patient clinical and/or financial needs and complication of required processes
Accurately completes a quality registration in the HIS system that maintains the integrity of demographic and financial information required for clinical and billing functions for every patient encounter
Understands and adheres to state and federal regulations and system policies regarding compliance, integrity and ethical registration practices.
Reviews and ensures that all medical orders are compliant and meet government and hospital guidelines as well as clinical protocols
Completes clinical screening for specified modalities to ensure patient safety
Ability to obtain insurance eligibility and benefit information from payors via phone, RTE, or web in order to provide patient with estimated responsibility for services requested or rendered
Responsible for all patient and claim edits for accuracy and compliance with all government and commercial carriers to ensure a clean claim submission
Works as a liaison with Centralized Referral Center or assigned entity to ensure prior-authorizations have been obtained to secure payment and prevent denials
Complete and/or process patient payments for account posting accuracy
Maintain an accurate cash drawer and functions related to cash drawer reconciliation and deposit
Responsible for practicing AIDET and all customer/patient related encounters
Performs other duties assigned by department supervisor or manager

Minimum Requirements

Required: High School Diploma or Equivalency.
Preferred: Associates or Bachelor's degree in Business or Healthcare related field

Required: Minimum three years' experience in healthcare access and/or customer service; Emphasis on financial analysis of insurance benefits for up front collections; Focused knowledge with CPT, HCPCS and ICD-10 codes; Excellent understanding of insurance and medical terminology; Solid Microsoft Office skills required with a focus on Excel and Word.

Preferred: Minimum four + years' experience in healthcare access, customer service; Minimum one year experience in a financial environment
Preferred: Certified Healthcare Access Associate (CHAA) or Certified Medical Insurance Specialist (CMIS)

Other Requirements
Responsible for production and adherence to measurable strategic departmental and system goals in relation to the expected

process of patient flow, prevention of denials and point of service cash collection performance measures
Excellent typing/keyboarding skills with a high degree of accuracy in inputting data
Ensures proper utilization of computer systems to facilitate efficient and effective work flow processes
Must possess excellent oral and written communication skills
Ability to complete detailed oriented work
Must possess a positive attitude and work well as part of a team as well as independently
Ability to maintain confidentiality and handle sensitive information
Prioritizing work responsibilities is a must in order to facilitate effective time management for task completion

Employment Type