Patient Access Specialist III

As part of Revenue Cycle Management, this position is responsible for creating a positive first impression of M Health Fairview and ensuring an exceptional experience is achieved while interacting closely with patients, families, and other internal and external stakeholders in a highly organized and professional manner. This position must utilize effective interpersonal skills to gather patient demographic for a complete and accurate registration, identifies insurance, gathers benefits, communicates, and collects patient's financial obligations. Individuals in this role are expected to demonstrate the M Health Fairview commitments (Integrity, Service, Compassion, Innovation and Dignity) along with critical thinking skills, a strong work ethic and flexibility.

3:00pm - 11:30pm / Monday thru Friday / Weekend Oncall rotation
Responsibilities

• Interview patients to obtain and document accurate patient demographic and insurance information in the medical record. Use insurance knowledge and resources to accurately code insurance and verify eligibility using online, web-based or phone systems to ensure accuracy and expedite payment.
• Perform check-in process including collection of co-pays, signatures on forms, scanning insurance cards and/or IDs and provide patient with any notices according to regulatory requirements. Support price transparency through patient education and collection on estimated financial responsibilities and refer patient to financial assistance/counseling resources as appropriate
• Interact with patients and families in challenging and unique situations that may require de-escalation skills.
• Manage daily worklists and/or work queues and resolve assigned tasks in a timely, accurate, and efficient manner. Assist mentoring new staff.
• Confirm insurance benefits for services including coverage limitations, referral or authorization requirements and patient liabilities.
• Provide proactive price estimates and communicate to patient to help them understand their financial responsibilities and collect. Inform patient of gaps in coverage, educate patient on available options and refer to financial counseling for assistance.
• Prepare and communicate/deliver notices of non-coverage to patients (ex: HINN, ABN, waiver, Medicare lifetime reserve days). Support/assist patient with billing or insurance questions. Support/assist patient with applications for assistance programs and refer to financial counseling.
• Onboard new staff. Support lead with other duties as assigned.
• Review and resolve accounts that are complex and require a higher degree of expertise and critical thinking. Liaison to leadership for financially risky situations.
• Expert on complex estimate creation. Generate estimates and analyze for accuracy, using the estimator tool with an understanding of managed care payment methodologies including, but not limited to, APC, DRG, per diem, fee schedules; adjusting data to re-calculate if necessary.
• Subject Matter Expert (SME) on department workflows.
• Collaborate and exhibit strong relationships with other departments and team to manage tasks, according to established criteria in a high-volume environment. Provide resources and contacts to patients as needed to ensure a seamless experience for the patient.
• Adhere to all compliance, regulatory requirements, department protocols and procedures. Protect patient privacy and only access information as needed to perform job duties.
• Contributes to the process or enablement of collecting expected payment
• Participates in improvement efforts and initiatives that support the organizations goals and vision. Understands and Adheres to Revenue Cycle’s Escalation Policy.
• Rotates between hospital emergency room and scheduled services for registered patients.
• Participates in weekend on-call rotation.

Required Qualifications

• 3 years in healthcare revenue cycle, health insurance or experience in an equivalent level 2 position.
• Patient collections experience in a medical setting.
• Effective communication skills (both written and verbal), attention to detail, self-directed and a positive attitude are essential.
• Ability to work independently and in a team environment

Preferred Qualifications

• Post Secondary Education
• Demonstrate the ability to perform accurately and efficiently in EPIC, Microsoft Office Suite, and other computer programs.
• Experience being a subject matter expert and demonstrated willingness to support team questions.

$23.61- $33.34 Hourly