Patient Access Specialist

• Perform admitting duties for all patients admitted for hospital services
• Assign accurate medical record numbers (MRNs)
• Complete medical necessity and compliance checks
• Provide patient instructions and collect insurance information
• Receive and process physician orders
• Utilize an overlay tool and provide excellent customer service
• Operate the telephone switchboard for incoming, outgoing, and inter-office calls
• Meet assigned point-of-service goals
• Use quality auditing and reporting systems to ensure accounts are corrected
• Conduct account audits and provide statistical data to Patient Access leadership
• Pre-register patient accounts before visits
• Make inbound and outbound calls to obtain demographic, insurance, and patient financial information
• Collect point-of-service collections and past-due balances, including payment plan options
• Explain consent and patient education forms, obtain necessary signatures, and witness signatures
• Review insurance eligibility responses and select applicable insurance plan codes
• Enter benefit data to support point-of-service collections and billing processes
• Screen medical necessity using Advanced Beneficiary Notice software
• Distribute and document ABNs and other designated forms and pamphlets

• Perform admitting duties for all patients admitted for hospital services
• Assign accurate MRNs and complete medical necessity and compliance checks
• Provide patient instructions and collect insurance information
• Receive and process physician orders
• Operate the telephone switchboard and relay calls
• Meet point-of-service goals and collect patient financial liabilities, past-due balances, and payments
• Conduct quality audits, correct accounts, complete forms accurately and timely, and provide statistical data to Patient Access leadership
• Pre-register patient accounts through inbound and outbound calls
• Explain consent and patient education forms, obtain signatures and witness names, and distribute required documents
• Review insurance eligibility responses, select insurance plan codes, and enter benefit data to support collections and billing
• Screen medical necessity using ABN software and distribute and document designated forms

• Perform admitting duties for all patients admitted for hospital services
• Assign accurate MRNs
• Complete medical necessity and compliance checks
• Provide patient instructions and collect insurance information
• Receive and process physician orders
• Utilize overlay tools while providing customer service
• Operate the telephone switchboard and relay incoming, outgoing, and inter-office calls
• Meet assigned point-of-service goals
• Use quality auditing and reporting systems to correct accounts
• Conduct account audits and provide statistical data to Patient Access leadership
• Pre-register patient accounts before visits
• Make inbound and outbound calls to obtain demographic and insurance information
• Collect point-of-service payments and past-due balances, including payment plan options
• Explain consent and patient education forms, obtain signatures, and witness names
• Review insurance eligibility responses and select applicable insurance plan codes
• Enter benefit data to support point-of-service collections and billing processes
• Screen Medicare medical necessity using ABN software and distribute required forms

• Provide patient access services for ancillary, diagnostic, surgical, and emergency services
• Act as a liaison between INTEGRIS, patients, providers, and payers for pre-care account resolution
• Perform complex registration, scheduling, demographic verification, point-of-service payments, consent collection, document imaging, and documentation
• Verify coverage eligibility and insurance, calculate patient portions, and process authorization requirements
• Adjust service area schedules and accommodate special requests
• Answer inbound calls and resolve patient, provider, and insurer concerns
• Collect patient payments and ensure financial clearance
• Document patient account activities, authorizations, and liability requirements
• Respond to inquiries about pre-care services, policies, coverage, benefits, and financial liability
• Resolve patient or payer inquiries and account or prior authorization issues
• Serve as a systems expert and resource for patient access specialists, including on-the-job training
• Provide staff guidance, feedback, training, assignment monitoring, and productivity assessment
• Coordinate team-oriented process improvement and continuous quality improvement initiatives
• Establish goals, track progress, and prepare data for presentation
• Maintain compliance with performance standards, regulations, policies, procedures, guidelines, and third-party contracts

Senior Patient Access Specialist

• Ensure complex registration activities, including scheduling, demographic verification, point-of-service payments, consent signatures, document imaging, and documentation standards
• Ensure complex patient access transactions, including coverage eligibility, insurance verification, patient portion calculation, and authorization requirements
• Adjust service area schedules and accommodate special requests from internal and external customers
• Answer inbound calls from patients, physician offices, and insurance carriers to resolve concerns
• Collect patient payments and ensure financial clearance
• Document patient account activities, authorization requirements, and patient liability
• Perform filing, data entry, and other assigned duties
• Respond to inquiries regarding pre-care services, policies, coverage, benefits, and financial liability
• Resolve patient or payer inquiries and prepare or review patient accounts and prior authorization requirements
• Communicate payer regulations, coverage benefits, and financial liability to patients
• Act as a liaison for complex patient access and account issues; answer reimbursement questions and serve as a resource and systems expert
• Provide guidance, feedback, on-the-job training, and performance improvement support to patient access staff
• Monitor assignments and assess productivity
• Handle telephone, email, and verbal communications with departments and caregivers
• Coordinate team-oriented process improvement initiatives
• Coordinate continuous quality improvement efforts, establish goals, track progress, and prepare data presentations
• Interpret and maintain compliance with performance standards, regulations, policies, procedures, guidelines, and contracts

• Ensure appropriate complex patient access transactions, including coverage eligibility, insurance verification, patient portion calculation, and authorization requirements
• Perform financial counseling, screen for government programs and financial assistance, explain payment options, process point-of-service payments, verify demographics, obtain signatures, and complete document imaging
• Adjust service area schedules and accommodate special requests from internal and external customers
• Accept inbound calls from patients, physician offices, and insurance carriers and resolve concerns
• Collect patient payments and follow authority levels to ensure financial clearance
• Document patient account activities, authorization requirements, and patient liability requirements
• Respond to inquiries about pre-care services, policies, coverage, benefits, and financial liability
• Use multiple resources to resolve patient or payer inquiries and prepare or review patient accounts and prior authorization requirements
• Explain payer regulations, coverage benefits, and financial liability to patients
• Maintain compliance with performance standards, EMTALA, HIPAA, regulations, policies, procedures, guidelines, and third-party contracts
• Follow safety rules, report accidents, and correct minor safety hazards