Location Address:

9521 San Mateo NE Albuquerque, NM 87113-2237

Compensation Pay Range:

Minimum Offer $16.38 Maximum Offer $25.57 Now Hiring: Patient Access Account Specialist I

Summary:

The Patient Access Account Specialist plays an important role in creating a positive patient experience by ensuring accurate and efficient registration, scheduling, insurance verification, and financial processing. This position serves as a key point of contact for patients and families while supporting the administrative and financial processes necessary for timely access to healthcare services. Type of Opportunity: Full time Job Exempt: No Job is based: Reverend Hugh Cooper Administrative Center Work Shift: Weekday Schedule Monday-Friday (United States of America)

Responsibilities:

*Addresses and attempts to appropriately resolve complaints in the moment by using key words at key times and de-escalation processes.
*Ability to manage conflict and appropriately request the help of a supervisor when needed.
*Educates patients for whom they speak regarding insurance benefits and liabilities.
*Ensures accounts are financially cleared prior to date of service to alleviate patient concerns over hospital financial matters
*Performs the patient registration process. Manage the accurate collection of patient data which includes but is not limited to;
*Obtain/confirm and enter demographic and other financial and clinical information necessary for final clearance of scheduled accounts.
*Review Urgent/Emergent admission accounts for notification, financial clearance and authorization pre-discharge.
*Obtain missing insurance information, to include policy number, group number, date of birth, and insurance phone number if not already identified in account.
*Verify insurance for eligibility and benefits using online electronic verification system or by contacting payer directly.
*Review and process work queues related to Patient Access pre-visit or urgent/emergent admissions, per department guidelines.
*Review of accounts falling within the work queues to ensure the insurance information contains accurate policy ID#s, Group Name and Numbers, Subscriber information, Authorization numbers, as well as correct payer and Coordination of benefits prior to date of service.
*Accurately document actions taken in the system of record to drive effective follow-up and ensure an accurate audit trail.
*Maintain ongoing knowledge of authorization requirements and payer guidelines. Maintain a proficient knowledge of Medicare (CMS) guidelines as it relates to admissions and outpatient services. Ensuring compliance with admissions forms, benefit entitlement verification, and billing requirements
*Ensure accurate completion of MSPQ prior to date of service.
*Work with payers to ensure authorization is in place; initiating the auth when appropriate.
*Coordinate efforts with Financial Advocates to secure payer source current and future visits.
*Monitor work queues to identify late add-on accounts and complete financial clearance procedures prior to services to avoid unauthorized procedures from being performed.

Qualifications:

*High school diploma, continued education preferred
*External and Internal Non-Patient Access Candidates: Pass Patient Academy with passing score of 85% or higher
*Previous completion and passing of Patient Access Advocate II and III Advancement test.
*A minimum of 2 years of work experiences in healthcare setting within Patient Access and/or billing plus strong customer service background.
*Strong knowledge and understanding of insurance and financial processing of accounts.
*Proficient in EPIC ADT system
*Specialty Certifications: CHAA, CHAM or other industry equivalent certification preferred
*Pass annual competency exam for all areas of responsibility.
*Requires general knowledge of the customer encounter process which may include registration, contract requirements, and coordination of benefits.
*Knowledge in Microsoft Office Products.
*Demonstrated strong keyboarding skills, ensuring efficient data entry and documentation.
*Pass EPIC proficiency test required with a 85% score at completion of the Epic Training class.
Candidates must be at least 18 years of age at the time of hire
 

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services