This is a PRN position located at St. Vincent Hospital
Schedule: day shift
The Patient Access Associate I obtains complete and accurate patient demographic, insurance (eligibility and/or verification), and financial information and collects all liability due for inpatients, outpatients, and emergency patients either face-to-face, by telephone, or internet.
- Registers patients. Confirms, enters, and/or updates all required demographic data on patient and guarantor on registration system. Avoids overlays and duplicate patient medical records. Follows procedures when identifying a patient and applying the patient identification bracelet. Registers patients during downtime following downtime procedures and enters data into registration system immediately upon system availability.
- Obtains and explains copies of insurance card(s), forms of ID, and signature(s) on all required forms. Verifies information on appropriate accounts to determine insurance coordination of benefits, pre-certification/prior-authorization if not verified by PASC. Completes the Medicare Secondary Payer (MSP) questionnaire when applicable. Verifies insurance to determine coordination of benefits and obtains authorization and/or referrals as required. Screens for and processes non-covered services and waiver of liability (ABN) through automated screening at time of service.
- Informs self-pay patients of liability due, prepayment requirements and coordinates screening of alternate funding sources if applicable. Prepares estimate of procedures, calculates advance payment requirements on previous or bad debt and current balances. Refers potentially eligible patients to financial counseling and/or contract eligibility vendor(s). Coordinates with clinical areas and other ancillary departments to obtain accurate orders in order to establish patient financial expectations.
- Collects patient payments and provides accurate receipt. Posts all payments in system. Reconciles receipts with cash collected and completes required balancing forms. Documents patient account notes for all interactions/transactions.
- Maintains departmental and/or individual work queues and reports as required. Explains/answers patient billing inquiries and interprets statement data to resolve accounts. Escalates account issues which cannot be resolved. Updates the emergency department room tracking system, if applicable.
- Meets departmental productivity and quality standards.
- Promotes mission, vision, and values of SCL Health, and abides by service behavior standards.
- Performs other duties as assigned.
- High School Diploma or equivalent
- Previous hospital/medical office, medical insurance and/or customer service experience is preferred.
Knowledge, skills and abilities:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements list must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Basic computer knowledge including experience with Microsoft Office Suite
- Respects and appreciates individual differences in perspective and background; recognizes others as individuals by showing respect for their beliefs/values and treating them with fairness and understanding.
- Understands the organization's mission, vision, values, and strategies and how they shape the organization and integrates the mission, vision and values into departmental activities and uses them as a guide in decision-making.
- Understands how the organization operates and evaluates the impact of his/her decisions on other work teams, promoting teamwork across the organization.