Patient Access Account Specialist I

Location Address: 9521 San Mateo NE
Albuquerque, NM 87113-2237
 Compensation Pay Range: Minimum Offer $16.38
Maximum Offer $25.57
Now Hiring: Patient Access Account Specialist I Summary: The Patient Access Account Specialist plays an important role in creating a positive patient experience by ensuring accurate and efficient registration, scheduling, insurance verification, and financial processing. This position serves as a key point of contact for patients and families while supporting the administrative and financial processes necessary for timely access to healthcare services.

Type of Opportunity: Full time
Job Exempt: No
Job is based: Reverend Hugh Cooper Administrative Center
Work Shift: Weekday Schedule Monday-Friday (United States of America)
 Responsibilities: *Addresses and attempts to appropriately resolve complaints in the moment by using key words at key times and de-escalation processes. *Ability to manage conflict and appropriately request the help of a supervisor when needed. *Educates patients for whom they speak regarding insurance benefits and liabilities. *Ensures accounts are financially cleared prior to date of service to alleviate patient concerns over hospital financial matters *Performs the patient registration process. Manage the accurate collection of patient data which includes but is not limited to; *Obtain/confirm and enter demographic and other financial and clinical information necessary for final clearance of scheduled accounts. *Review Urgent/Emergent admission accounts for notification, financial clearance and authorization pre-discharge. *Obtain missing insurance information, to include policy number, group number, date of birth, and insurance phone number if not already identified in account. *Verify insurance for eligibility and benefits using online electronic verification system or by contacting payer directly. *Review and process work queues related to Patient Access pre-visit or urgent/emergent admissions, per department guidelines. *Review of accounts falling within the work queues to ensure the insurance information contains accurate policy ID#s, Group Name and Numbers, Subscriber information, Authorization numbers, as well as correct payer and Coordination of benefits prior to date of service. *Accurately document actions taken in the system of record to drive effective follow-up and ensure an accurate audit trail. *Maintain ongoing knowledge of authorization requirements and payer guidelines. Maintain a proficient knowledge of Medicare (CMS) guidelines as it relates to admissions and outpatient services. Ensuring compliance with admissions forms, benefit entitlement verification, and billing requirements *Ensure accurate completion of MSPQ prior to date of service. *Work with payers to ensure authorization is in place; initiating the auth when appropriate. *Coordinate efforts with Financial Advocates to secure payer source current and future visits. *Monitor work queues to identify late add-on accounts and complete financial clearance procedures prior to services to avoid unauthorized procedures from being performed. Qualifications: *High school diploma, continued education preferred *External and Internal Non-Patient Access Candidates: Pass Patient Academy with passing score of 85% or higher *Previous completion and passing of Patient Access Advocate II and III Advancement test. *A minimum of 2 years of work experiences in healthcare setting within Patient Access and/or billing plus strong customer service background. *Strong knowledge and understanding of insurance and financial processing of accounts. *Proficient in EPIC ADT system *Specialty Certifications: CHAA, CHAM or other industry equivalent certification preferred *Pass annual competency exam for all areas of responsibility. *Requires general knowledge of the customer encounter process which may include registration, contract requirements, and coordination of benefits. *Knowledge