PATIENT ACCESS ASSOCIATE - A NOMC ADMISSIONS

North Oaks Health System - Hammond, LA

Full-time

Hammond, LA

Religious, Grantmaking, Civic, Professional, and Similar Organizations

About the position

To provide excellent customer service during the patient access/intake process according to established hospital procedures. The Patient Access Associate (PAA) executes patient access through the continuum of the revenue cycle that supports patient safety, efficiency, cost reduction and service improvement. Patient Access includes the patient's pre-encounter, encounter and post-encounter which include accurate and efficient patient registration, insurance verification, scheduling, and pre-service collections in compliance with payer and facility rules and regulations.

Responsibilities

• Assist patients and visitors as needed to ensure timely access to medical services.
• Work effectively to ensure the highest regard to customer service is given to every patient, customer, practitioner's office, and every department that utilizes the Patient Access department.
• Ensure timely and safe access to medical care by completing patient scheduling, insurance verification, and registration processes in an efficient, accurate and timely manner according to department guidelines.
• Support the Patient Access Department role in the revenue cycle by scheduling according to physician orders, reviewing insurance documents verifying coverage, updating all insurance information in the patient's registration, estimating financial responsibility and collecting payments according to the Patient Access and Hospital policies and procedures.
• Ensure legal compliance, patient safety, and system financial integrity by performing state license verification, sanction and exclusion verification as well as NPI verification on all providers not already listed in the hospital information system.
• Communicate the purpose of and secure patient signatures as required by department procedures on documents including Conditions of Treatment form, Notice of Privacy Practices (HIPAA), Advanced Directives, Patient Rights, Important Message from Medicare (IMM), Medicare Secondary Payer (MSPQ), ABN, Financial Disclosure and any other facility required forms or documents required to meet JCAHO, CMS, and DHH requirements.
• Contact patients and provider offices by phone using excellent customer service to obtain patient demographic and insurance information, schedule ordered services, and provide financial responsibility information to support timely and accurate billing of all payers.
• Perform insurance verification and authorization/pre-certification processes for all NOMC patients according to the Patient Access Department guidelines.
• Demonstrate basic knowledge of payer types including Commercial, Medicare, Medicaid, Other Governmental, Worker's compensation, Managed care, and Self-pay.
• Recognize diagnosis and CPT codes as necessary to complete scheduling, registration, insurance verification, authorization, notification, price estimates and order transcription as assigned.
• Ensure Emergency Medical Treatment and Labor Act (EMTALA) compliance by registering patients according to department/hospital guidelines.
• Document in appointment and/or account notes any issues related to scheduling, insurance verification or registration of the patient.
• Interact with relevant departments to problem solve and coordinate any concerns related to patient identification, registration, scheduling, insurance verification, or billing issues.
• Assist in patient conflict resolution to ensure timely access to care and facilitate a positive patient experience.
• Resolve hospital account errors and claim edits timely and accurately to support the facility's financial goals.
• Comply with all Patient Access Department and hospital safety, environmental and infection control policies and procedures.
• Follow North Oaks Health System's Compliance Program and Federal and State Regulatory Guidelines.
• Enhance professional growth by participating in education programs and department meetings as required.
• Provide backup to the Patient Access Assistant as needed.
• Perform all duties as directed by the Patient Access Department Supervisor, Manager, and Director/Designee.
• Provide assistance, guidance, and directions to visitors, patients, employees, vendors and physicians.
• Maintain competency in Service Recovery utilizing AAA (Acknowledge, Apologize, Amend).
• Maintain personal appearance following the department and facility's dress code.
• Maintain the appearance of the waiting/lobby area.
• Establish effective relationships with co-workers in own department as well as other departments.
• Perform appropriately in difficult situations by remaining calm and notifying appropriate personnel.
• Respond to inquiries from patients, relatives, physicians, insurance companies and the general public quickly and efficiently.
• Keep any confidential documents secure and out of the public view.
• Maintain par level of supplies and communicate to immediate supervisor when supplies are needed.
• Ensure all equipment is functional and ready for service, including paper levels in copiers, printers, and fax machines.

Requirements

• High School Diploma is required.
• One year of previous experience in healthcare field or customer service required.
• Bachelor's degree can be substituted for one year of experience.
• Experience in healthcare patient access, billing or other healthcare revenue cycle field is preferred.
• Experience in healthcare admissions, registration, or billing preferred.
• Medical Terminology desired.
• Ability to communicate over the telephone.
• Excellent customer service skills.
• Must be able to interpret complex documents related to insurance benefits.
• Must be able to read and understand required components of physician's orders.
• Requires judgement to accurately establish patient identity and assign insurance information according to payer and facility guidelines.
• Intermediate computer skills required; ability to operate a computer using Word, Excel, and email, fax machines, printers, and copiers.