The Patient Access Associate I is responsible for the patient registration process, general admissions, and financial assistance processing. This position verifies third party payor accounts, pre-authorization and/or pre-certification requirements. The Patient Access Associate I communicates and collaborates with Patient Access team members and other ancillary departments as needed.
The Patient Access Associate I will be knowledgeable of state and federal government funding programs such as Medicare, Medicaid, TRICARE/CHAMPUS, Workers' Compensation; No Fault Auto, and commercial insurance payers; billing and reimbursement guidelines and methodologies for state and federal government and non-government payers; insurance terminology; medical terminology, EMTALA, HIPAA privacy, and compliance practices.
The Patient Access Associate I is responsible for verifying diagnosis codes, completing medical necessity checks for Medicare, completing patient estimates for self- pay population, and consumer shopper comparison. The Patient Access Associate I must have basic knowledge of ICD-10 and its predecessor ICD-9 in order to ensure accurate diagnosis entry for reimbursement.
The Patient Access Associate I will perform duties after six-week training program under the supervision of the Patient Access management team. This position is a customer service champion responsible for delivering great customer service at each entry point throughout the health system. This position is also responsible for patient throughput, established wait times and turnaround (TAT) times for all Patient Access areas along with aiding in the achievement of top box customer service scores for each respective Patient Access site.
The Patient Access Associate I must pass annual recertification with score of 90% or better. The Patient Access Associate I can perform job duties based on department procedure and protocol; may require direct oversight. Attends all required trainings and in-services and passes all competency tests associated with the in-services.
This position maintains high accuracy rate of A and established productivity rates for Key Performance Indicators (KPI) such as cash collections, wait and TAT times, and pre-registration and registration productivity.
The Patient Access Associate I must achieve Valued Contributor or above on their annual evaluation with no written disciplinary documents on file. The Patient Access Associate have the opportunity for advancement to Patient Access Associate II if all of the above requirements are satisfied and the incumbent has been in the role for one year. In order to advance via the Patient Access Career Path, the Patient Access Associate I must pass the annual recertification with a minimum score of 95%. The Patient Access Associate I must achieve an evaluation rating of value contributor the year of consideration and every year after. If the valued contributor rating is not achieved in the following years, an action plan will be put in place to remediate the staff member back to valued contributor and no further considerations for the career path program will be allowed until the staff member formally achieves valued contributor on their next annual evaluation.
This position supports organizational goals by providing high level, quality customer service, participating in performance improvement efforts, demonstrating a commitment to teamwork and cooperation while verifying and preparing all patient accounts for inpatient and outpatient billing in order to maximize payment for Hospital and Clinic services from all sources.
EDUCATION: High school diploma or equivalent required. Associate's degree preferred. Ability to communicate effectively both orally and in writing sufficient to perform the essential functions; read, understand, and apply policies and guidelines; obtain information from a variety of sources is required. Bilingual preferred.
EXPERIENCE: 0-1 year experience in Healthcare registration or relevant customer service environment required. Knowledge of general computer and data entry functions required. Previous experience in a physicians' office or hospital setting is preferred. Excellent communication, organizational and analytical skills required. Ability to keep up in very fast paced environment required. Candidates must continuously display professionalism, courtesy and respect to all customers that always mirror AtlantiCare's Values/Behaviors. Candidate must have reliable means of transportation.
Demonstrates the competencies as established on the Assessment and Evaluation Tool for this position.
Potential for exposure to the hazards and risk of the hospital environment, including exposure to infectious disease, hazardous substances, and potential injury.
This position requires reaching, stooping, kneeling, and crouching approximately 25% of the workday. This position requires frequently lifting, approximately 25-30 pounds, and occasional lifting of 50-100 pounds with assistance. This position also requires pushing and pulling computers on wheels approximately up to 100% of the day if assigned to the Emergency Department or Labor and Delivery. High volume fast-paced environment.
The essential functions for this position are listed on the Assessment and Evaluation Tool.