General Purpose of Job:

The Patient Access Specialist is responsible for working with patients, family, visitors, staff, and physicians to provide a customer service focused patient encounter in many areas of the hospital, not limited to but including Emergency Department, Pre-registration, Outpatient Registration, Switchboard and Information Desk. The time commitment for a Patient Access Specialist can also vary in hours considering the hospital operates 24 hours a day providing optimal patient flow during peak times. The Patient Access Specialist is responsible for accurately collecting and verifying insurance information, determining coordination of benefits, interpreting patient payment calculations, and communicating the necessary information throughout the hospital revenue cycle.

Essential Duties:

This job description is intended to cover the minimum essential duties assigned on a regular basis. Caregivers may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

• Interviews patients for the purpose of entering confidential patient insurance and demographic information into the STAR system. Performs registration or pre-registration of all patient types.
• Collect complete and accurate demographic and financial information while in compliance with federal regulations such as HIPAA and EMTALA. Obtains signatures and information as required by regulatory agencies.
• Verify insurance eligibility and covered benefits by using all electronic systems available to them or verification by phone according to departmental policy. Collect and verify necessary authorizations as appropriate and possess knowledge of financial class requirements with regard to registration and insurance requirements. Document financial information in the accounts for billing purposes.
• Educates the patient as to their financial responsibility prior to the point of service by providing the patient with cost estimates for services rendered. Collect and post pre-payment or point of service payment for hospital services.
• Operates multiple computer applications to register patients, enter orders, and retrieve surgical, testing, insurance and financial information.
• Serves as a liaison between Central Scheduling, decentral scheduling areas and clinical staff.
• Assist uninsured/under-insured patients by screening for all available assistance programs, including community, state and federal programs in order to secure payment for the hospital.
• Coordinates with other departments or areas to obtain required data or financial clearance elements or to escalate issues when necessary.
• Works exception accounts held internally or rejected by payers for errors related to registration and financial clearance activities.

Job Requirements