Patient Access Spec - ED

Patient Access Specialist

The Patient Access Specialist is responsible for the capture of demographic and insurance information either by telephone or patient facing. Position is required to use eligibility application to invoke request to verify insurance eligibility, interpret response and capture appropriate health insurance information as it pertains to the service being rendered. The position requires ability to understand and apply contractual benefits to the service being rendered, with ability to have a financial discussion with patient regarding payment responsibility. Must be comfortable in the collection of financial responsibility from the patient based on eligibility response or estimate for services.

Essential Duties and Responsibilities

• Responsible for creating encounters in ADT representing service patient is receiving
• Responsible for discerning demographic and insurance information to ensure accurate registration
• Responsible for interpreting information received from insurance payer regarding patient's eligibility and financial responsibility
• Responsible for discussing financial obligation of patient and collecting via cash, credit card, or check
• Responsible for explaining regulatory forms and answering questions from patient; obtaining signatures accordingly
• Responsible for scanning or managing online form template to maintain the Electronic Health Record
• Comprehend federal, state, third-party payer regulations as it pertains to a hospital registration
• Ability to work in multiple systems during a telephone call or patient facing interaction to complete an accurate registration and support clinical workflow
• Responsible for reviewing services being rendered to ensure the appropriate setting of care has been assigned by the physician's office; if not, physician staff will be advised of the contractual or regulatory expectation warranting a change of setting of care
• Ability to respond to requests for estimates for service being rendered or expected to be rendered
• Contact patient if issues or data missing impeding ability to financially secure encounter
• Responsible for securing encounters with extremely tight timeframes due to late booking of service

Qualifications

• High School Diploma/G.E.D. - required
• Associate's Degree relevant area of study
• 3 5 years experience in a hospital or physician office - required
• Strong computer skills
• Strong insurance knowledge regarding payer contract interpretation including Authorization Requirements and Setting of Care (High proficiency)
• Proven customer service skill with ability to exceed expectations
• Ability to multi-task in stressful and high patient volume unit; must be able to manage pressure of very tight timeframes to execute task
• Ability to learn in a classroom setting; utilizing resources
• Ability to remain composed under pressure
• Ability to review information and draw appropriate conclusion
• Good judgement and ability to be resourceful to problem solve; escalate issues as needed
• Team-minded work ethic
• Demonstrated ability to interpret patient's insurance benefits and apply the applicable contractual obligations
• Critical thinking ability regarding issues with financially securing payment
• Ability to discuss sensitive concepts with patients regarding financial obligations
• CHAA - Certified Healthcare Access Associate upon hire or acquired within 2 years of hire within 1-1/2 Yrs - required

Thank you for your interest in Albany Medical Center! Albany Medical Center is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a "need to know" and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.