OverviewThe Patient Access Healthcare Associate II must be competent in the following: registering, insurance/Medicare/Medicaid compliance and strong customer service skills, performing phlebotomy, EKG tracings and processing drop-off specimens. The Patient Access Healthcare Associate must have the ability to work independently in a fast-paced environment. The Patient Access Healthcare Associate must project a mature, compassionate, concierge-style customer attitude and professional demeanor. Interacting in a customer-focused and compassionate manner to ensure patients and their representatives needs are met, and that they understand the hospital's revenue cycle expectations, including resolution through various payment options. The Patient Access Healthcare Associate will accurately collect, analyze and record demographic, insurance/financial and clinical data from multiple sources, and obtains other information and signatures necessary for registration and billing. Effectively screens for compliance with payer requirements for medical necessity and precertification and completes third-party eligibility and benefit verification to ensure accurate payment is secured.
ResponsibilitiesPART III: POSITION RESPONSIBILITIES (ESSENTIAL FUNCTIONS)Accurately collects and analyzes all required demographic, insurance/financial, and clinical data necessary to schedule, pre-register, and register patients from all payer classes interacts with patients, their representatives, physicians, physician office staff, employers, and others, and reviews new and previously recorded information, electronically records information on a timely basis, follows EMTALA, HIPAA, payer and other applicable regulations and standards for registration.Accurately prepares required forms, documents, and reports, including labels, medical record forms, and other documents. Produces and distributes these on a timely basis to both internal and external parties. Completes orders as designed by test request for physician orders.Analyzes and records data and processes transaction to ensure that an accurate historical patient data base is maintained for each registration encounter.Analyzes available documentation and uses hospital resources to calculate the amount expected from the payer and the amount owed by the payer and the amount owed by the patient or responsible party. Provides the information to patients to ensure they understand the policies that govern the revenue cycle and the processes that will be followed. Appropriately explains, secures, and witnesses all signatures required to provide medical treatment, assignment of benefits release of information, establish financial responsibility and to assist in meeting other internal, regulatory and payer requirements. Completes the MSP questionnaire when applicable.Assist in training of new personnel and other health care staff.Assist with procedures and diagnostic testing for pre-op testing. Perform routine EKG tracings.Assists in clinics or other departments needs as necessary including: 1. Escort patients to exam rooms, 2. Take vital signs-Height, weight, blood pressure 3. Assist with procedures and diagnostic test upon request 4. Assist with documentation when requested. Assists in specimen collection for community health screenings, employee health physicals, and all other departments as requested.Conducts reminder calls to patients for appointments and pre-registers scheduled patients. Assists with transportation of patients within the hospital, and in securing transportation of patients to and from the hospital. Sorts and distributes mail and faxes. Keeps patient and family informed of process and any delays.Determines from callers appropriateness of services to be provided in department and other locations to ensure proper information is provided to patient or their representative prior to arrival. Provides preps and instructions to patients to ensure necessary steps are taken prior to tests/procedures.Draw tubes in correct order to avoid contamination or carryover in specimen. Make sure all tubes are full or filled to an acceptable level for all. Appropriately labels, stores and transport all specimens according to laboratory policies and procedures. Notify supervisor(s) when unable to collect an acceptable specimen after two (2) attempts or of any unusual problem(s) with specimen, patient, physician, orders, etc. Ensure area and procedures performed are within compliance with regulatory agencies.Explains hospital credit and collection policies and payment options to the patient or responsible party, and negotiates acceptable resolution of expected self-pay balance. Refers self-pays to financial counselor or cashier. In absence of cashier, collects payments.Identifies self to all patients or their representatives during direct or phone interactions and provides greeting to help customer determine appropriate location and process to occur. Maintain patient flow-ambulatory care, pre-op testing and clinics. Maintain log of all patients and procedures.Meets any departmental competency requirements; Lotus Notes, P & P, and Disaster Competency. Attends all advanced registration classes and mandatory department meetings.Obtain specimens utilizing venipuncture and other means of collection. Confirm special requirements for specimen acceptability before and or after delivery of specimen. Collect and deliver specimens to appropriate department with the defined time limits requiring. Verify identification and labeling of all specimens received. Complete registrations for specimen drop-offsReceives, properly responds to, or redirect telephone, electronic and in-person inquiries from patients, their representatives, payers physicians and their staff, UR, internal departments, and other persons. Maintains confidentiality of personal health information working within the minimum necessary guidelines.Reviews and analyzes records of active patients to identify and resolve situations where care is different than originally identified, including reverification of payer information, reverification of medical necessity, revising and informs all affected parties.Reviews physician orders and other documentation against payer coverage and medical necessity criteria, uses screening software to determine whether services being provided meet third-party requirements for payment, contacts physicians as necessary for additional clinical information; informs physicians about payer requirements, initiates to Medicare ABN process as appropriate and explains payer policies to patients. Documents in notes all financial expectations of payer or patient and medical necessity verification.QualificationsExperience/Education Requirements:High school diploma or its equivalentPhlebotomy experience preferredEKG tracings preferredComputer literate, 35 WPM minimum requirement.Must have spelling accuracy.Medical terminology preferrredOffice or other clerical experience preferredAbility to read and write in English. Verbal skills required to interact on the telephone or in person in a courteous and respectful manner.Ability to do general arithmeticPrior knowledge of payer regulatory compliance and HIPAA Privacy and Security requirementsDetail oriented, committed to accuracy, ability to problem solveUnderstanding of the hospital revenue cycle
License or Certification Requirements:

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