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Patient Access Account Specialist II
Presbyterian Healthcare Services - Albuquerque, NM
posted 2 months ago
About the position
The Patient Access Account Specialist II plays a crucial role in ensuring financial clearance for patient accounts prior to service dates. This position involves verifying insurance, collecting patient demographics, conducting benefit analysis, and providing financial counseling. The specialist acts as a subject matter expert within the Patient Access department, ensuring compliance with Medicare and other regulatory guidelines while delivering exceptional customer service to patients and ancillary departments.
Responsibilities
- Perform financial clearance functions for patient accounts including insurance verification and authorization.
- Collect and document patient demographics and financial information accurately.
- Educate patients on their insurance benefits and financial obligations.
- Monitor work queues for missing authorizations and ensure payment sources are secured.
- Assist in training new hires and shadowing Patient Access candidates.
- Coordinate with ancillary departments to ensure compliance with payer requirements.
- Collect patient financial obligations prior to service and provide financial options.
- Maintain accurate records and documentation in the system of record.
- Perform risk management activities and report any violations promptly.
Requirements
- High school diploma or GED required; continued education preferred.
- Minimum of 3 years of work experience in a healthcare setting, with at least 2 years in Patient Access or billing.
- Strong customer service background and conflict management skills.
- Proficient knowledge of Medicare guidelines and compliance regulations (HIPAA, EMTALA).
- Extended knowledge of medical terminology and billing codes (DRG, ICD-10, CPT, HCPCS).
- Proficient in EPIC ADT system and must pass annual competency exams.
Nice-to-haves
- Specialty certifications such as CHAA, CHAM, or equivalent preferred.
Benefits
- Comprehensive medical, dental, and vision insurance.
- Short-term and long-term disability insurance.
- Group term life insurance and optional voluntary benefits.
- Employee wellness program with rewards for participation.
