Patient Access Asso Level I

Identifies and obtains payor authorizations, pre-certifications, and/or referrals. Provides appropriate documentation and follow up to physician offices, case management department, and payors regarding authorization/referral deficiencies. Responsible for communicating to service line partners of situations where rescheduling is necessary due to lack of authorization and/or limited benefits and is approved by clinical personnel.
In working inpatient accounts, is held responsible for timely notification to payers of the patient’s admission to the facility.
Identifies all patient financial responsibilities, calculates estimates, collects all payments due, including current estimated liabilities, outstanding balances and self-pay deposits, posts payment transactions in the system and performs daily reconciliation. Identifies self-pay and complex liability calculations and escalates account to Financial Counselors as appropriate. Responsible for all estimates requested for consumer shopper comparison.
Appropriately collects and/or sets payment arrangements with patients of their representative, scheduling payments on deposits due, which may include screening of patients for enrollment in available credit option programs. Documents all attempt for collections, using approved verbiage, timely, and consistently. Proactively seeks assistance to improve collections.
Ensures all patients with questions or concerns regarding their bills are referred to the appropriate resource, to include initiation of financial counseling, when appropriate.

QUALIFICATIONS

EDUCATION AND EXPERIENCE:
High school diploma or equivalent required.
0-1 year experience in Healthcare registration or relevant customer service environment required.
Previous experience in a physicians' office or hospital setting is preferred.
The Patient Access Associate I can perform job duties based on department procedure and protocol; may require direct oversight
LICENSE/CERTIFICATION:
Healthcare Financial Management Association - HFMA (CRCR) Certified Revenue Cycle Representative certification preferred, not required
KNOWLEDGE AND SKILLS:
Must pass annual recertification with score of 95% or better. This requirement is expected to be maintained every year. Staff members will be required to re-take training and exam until they obtain the appropriate grade or disciplinary action will be taken in regards for performance.
Maintains a high accuracy rate of 98% or higher and established productivity rates for Key Performance Indicators (KPI) such as cash collections wait and TAT times, pre-registration and registration productivity.
The Patient Access Associate has the opportunity for advancement to Patient Access Associate II if all of the above requirements are satisfied and the Patient Access Associate has been in the role for 15 months.