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Patient Access Specialist

Company Children's Hospital & Medical Center - Omaha
Location Omaha, NE
Update 9 Day ago
300
Just like the children we serve, Children's is growing quickly and hiring a Patient Access Specialist who will facilitate the admission and registration process for all inpatients and outpatients. Obtain essential information for registration and pre-certification, ensures all data is accurate, forms are complete and signed for inpatients, surgical, diagnostic and clinical outpatients. Establish good rapport with and maintain effective communication with patients, parents, physicians, house officers, nursing staff and others. Advise patients of financial responsibilities and payment expectations.

                        • Essential Functions/Competencies

                        • OUTPATIENT CLINIC, EMERGENCY, AND ANCILLARY REGISTRATION. Receives notification of need for registration/reservation from patient, caregiver, physician, physician agent, surgery scheduling, nurses, or clinics & can identify specific registration protocol based upon patient clinic type.
                          • Obtains complete and accurate patient, demographic and insurance information, identifying all payment sources and pre admission certification requirements to enhance the revenue cycle and prevent denials of reduction in benefits.
                          • Assembles forms/patient packets as necessary.
                          • Converts pre registration to visit when a patient/family arrives in a timely manner and assembles patient charts when required.
                          • Responsible for verifying all demographic information is complete and accurate in both AM and Epic registration systems and communicates such information to all parties involved.
                          • Obtains complete and accurate data at the bedside for patients when appropriate, thus supporting the medical needs of the patient.
                          • Obtains authorization for medical treatment/testing or admission from parents or legal guardian. Seeks to obtain accurate sociologic information to ascertain responsibility for signing the Authorization for Treatment. Refers to Social Worker when legal guardianship issues arise.
                          • Distributes Privacy Notice to parents and obtains written acknowledgement of receipt of notice.
                          • Communicates NeHii disclosure and documents in Registration system(s)
                          • Obtains copy of driver’s license or other picture identification in accordance with red flag policy and procedures.
                          • Prompts the collection of co-payment, deductible, co-insurance or deposit of self-pay balances at this time of registration if not previously collected.
                          ADMISSIONS - Receives notification of need for registration/admission from physician, physician agent, surgery scheduling, nurses, or clinics.
                          • Assembles forms as necessary.
                          • Places wristband with verified demographic information directly on patient at point of admission.
                          • Obtains complete and accurate patient, demographic and insurance information, identifying all payment sources and pre admission certification requirements to enhance the revenue cycle and prevent denials of reduction in benefits.
                          • Prompts the collection of admission co-payment when identified during the insurance verification process.
                          • Obtains complete and accurate data at bedside for all nonscheduled admissions, when appropriate, thus supporting the immediate medical needs of the patient.
                          • Coordinates bed assignment with the Clinical Nurse Coordinator. Monitors bedside registration and ED Bed Board.
                          • Obtains authorization for medical treatment/testing or admission from parents or legal guardian. Seeks to obtain accurate sociologic information to ascertain responsibility for signing the Authorization for Treatment. Refers to Social Worker when legal guardianship issues arise.
                          • Creates admission visit with appropriate status, bed type, and accommodation when a patient/family arrives, notifies the CNC or assigned floor and assembles patient charts.
                          • Determines if patient is an adult in Nebraska for completion of Advance Directive status. If there is an Advance Directive instructs patient/parents that it must be placed on the chart. If of legal age and no Advance Directive, provides information on creating an Advance Directive. Documents correctly in AM and Epic
                          • Assumes responsibility of daily follow-up with Signature Bin with emphasis on collection of insurance information for timely authorization
                          • Issues proximity cards to parents in Access from 7AM-8PM and Security resumes responsibility around those hours.

                        • FINANCIAL RESPONSIBILTIES - Identifies, collects and accepts copayments and payments on account at time of registration. Also looks for existing or prior balances and works to collect those. Refers family to Patient Financial Counselor for assistance when required.
                          • Posts payment to account at time of collection according to system protocol
                          • Reviews all sources for balance due within Epic and Eclipsys upon patient arrival and makes attempt to collect.
                          • Assures completion of Self-Pay Form for all true self-pay accounts and forwards to Patient Financial Counselor.
                          • Obtains ABN form when applicable.
                          • Completes daily deposit and manages cash drawer to ensure balancing and posting needs are met according to the department.
                          • Develops working knowledge of insurance companies and their requirements.
                          • Verifies Medicaid eligibility through NMES line or N-Focus/ web eligibility, and/or Americhoice.
                          • Utilizes Passport electronic eligibility on all applicable payors for eligibility and to determine out of pocket patient responsibilities
                          • Utilizes available websites for non-Passport eligibility inquiries.
                          • Calls insurance company to initiate the pre certification/referral process when not already in place for lab/rad/clinic visits.

                        • ADDITIONAL RESPONSIBILITIES
                          • Enters into AM all patient transfers, discharges, expirations and physician notification changes
                          • Answers and directs multi-line phone within 2-3 rings.
                          • Completes Add/Change physician form when physician not in AM pull down menu, routes completed form to Medical Staff Office & follows through with updating patient registration once physician has been added to AM.
                          • Coordinates Outpatient Ambulatory Ancillary services & can identify specific registration protocol based upon patient clinic type.
                          • Completes opening and closing department routines including separating and sorting reports generated by computer and fax, filing or delivering reports to the appropriate person, and giving shift change report.
                          • Receives and transports specimens collected outside of the facility.
                          • Coordinates with CyraCom or in-house interpreter to facilitate registration of limited English proficiency customers.

                          Perform physical requirements as described in the Physical Requirements section

                          Regular attendance at work is an essential job function.

                          SECONDARY FUNCTIONS/COMPETENCIES

                        • Performs other related duties as assigned.


                        • KNOWLEDGE, SKILLS AND ABILITIES:
                          • Knowledge of medical terminology.
                          • Knowledge of billing CPT and ICD coding preferred.
                          • Ability to type 40 words per minute with accuracy.
                          • Ability to pay attention to detail.
                          • Ability to provide a pleasant and welcoming appearance to all with which you come in contact.
                          • Ability to read, write, type, and follow oral and written directions.
                          • Ability to work with minimal supervision.

                          EDUCATION AND EXPERIENCE:
                          • High school diploma or GED equivalent required.
                          • Minimum one year customer service experience required.
                          • One year experience working in a health care or insurance setting preferred.

                          CERTIFICATIONS/LICENSURE REQUIREMENTS:
                          • Current and valid Basic Life Support (BLS) preferred.