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Patient Access Advocate-Senior
Presbyterian Healthcare Services
Santa Fe, UAE
Full Time
Senior
3 weeks ago
Insurance VerificationMedical TerminologyICD 10CPT 4EPICMicrosoft Office
Free
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Insurance VerificationMedical TerminologyICD 10
About the Role
Presbyterian Healthcare Services seeks a Senior Patient Access Advocate to perform financial clearance of patient accounts, including insurance verification, authorization, and collection.
Key Skills for This Role
Insurance VerificationMedical TerminologyICD 10CPT 4EPICMicrosoft Office
Responsibilities
- Provide all services needed to resolve the financial clearance of patient accounts of government and commercial accounts prior to billing
- Perform all financial clearance functions, including insurance verification, authorization, collection and documentation of patient demographics
- Quality assurance of registration data, benefit analysis, financial counseling, and pre and post service collections
- Achieve exceptional patient experience by using CARES, AIDET and EPE tools
- Address and attempt to appropriately resolve complaints in the moment
- Educate patients regarding insurance benefits
- Ensure accounts are cleared for billing to alleviate patient concerns
- Perform patient registration process and manage accurate collection of patient data
- Review Urgent/Emergent admission accounts for notification, financial clearance and authorization post discharge
- 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 to ensure claims are submitted timely and accurately
- Maintain strong knowledge of Medicare (CMS) guidelines as it relates to admissions and outpatient services
Requirements
- High school diploma/GED
- Internal Candidates: 5 years experience in healthcare setting with 2 years of Patient Access and/or billing plus strong customer service background
- Previously passed Patient Access Advocate II, III and Specialist Advancement tests
- CHAA, CHAM or other industry equivalent certification preferred
- Expert knowledge of insurance and financial processing of accounts
- Expert knowledge of medical terminology and billing codes (DRG, ICD 10, CPT, HCPCS)
- Proficient in EPIC ADT system
- Proficient in Microsoft Office Products
- Candidates must be at least 18 years of age at the time of hire
Full Job Posting
Summary
- The Senior Patient Access Advocate provides all services needed to resolve the financial clearance of patient accounts of government and commercial accounts prior to billing.
- Performs all financial clearance functions, including insurance verification, authorization, collection and documentation of patient demographics, quality assurance of registration data, benefit analysis, financial counseling, and pre and post service collections.
- Type of Opportunity: Full time. Job is based: Remote Workers New Mexico. Work Shift: Weekday Schedule Monday Friday.
Responsibilities
- Achieve exceptional patient experience for patients and patient families by using CARES, AIDET and EPE tools.
- 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.
- Implement PROMISE and CARES behaviors in every encounter.
- Educates patients for whom they speak regarding insurance benefits.
- Ensures accounts are cleared for billing 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 and Urgent/Emergent patient accounts.
- Review Urgent/Emergent admission accounts for notification, financial clearance and authorization post discharge.
- Obtain missing insurance information which can include policy number, group number, date of birth, and insurance phone number if information is missing from 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 to ensure claims are submitted timely and accurately, per department guidelines.
- Quality 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 billing.
Qualifications
- High school diploma/GED.
- Internal Candidates: 5 years experience in healthcare setting with 2 years of Patient Access and/or billing plus strong customer service background.
- Previously passed Patient Access Advocate II, III and Specialist Advancement tests.
- CHAA, CHAM or other industry equivalent certification preferred.
- Expert knowledge of insurance and financial processing of accounts.
- Expert knowledge of medical terminology and billing codes (DRG, ICD 10, CPT, HCPCS).
- Proficient in EPIC ADT system; include scheduling, registration, contract requirements, financial guidelines, coordination of services and billing process.
- Proficient in Microsoft Office Products.
- Candidates must be at least 18 years of age at the time of hire.
Compensation
- Minimum Offer $19.25 Maximum Offer $28.62.
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