Patient Access Specialist

Patient Access Specialist

The Patient Access Specialist is responsible for the capture of demographic and insurance information either by telephone or patient facing. Position is required to use eligibility application to invoke request to verify insurance eligibility, interpret response and capture appropriate health insurance information as it pertains to the service being rendered. The position requires ability to understand and apply contractual benefits to the service being rendered, with ability to have a financial discussion with patient regarding payment responsibility. Must be comfortable in the collection of financial responsibility from the patient based on eligibility response or estimate for services.

Essential Duties and Responsibilities :

• Responsible for creating encounters in ADT representing service patient is receiving
• Responsible to discern demographic and insurance information to ensure and accurate registration
• Responsible to interpret information received from Insurance Payer regarding patient's eligibility and financial responsibility
• Responsible to discuss financial obligation of patient and collect via cash, credit card or check
• Responsible to explain regulatory forms and answer questions from patient; obtain signatures accordingly
• Responsible for scanning or managing online form template to maintain the Electronic Health Record
• Comprehend Federal, State, Third Party Payer regulations as it pertains to a hospital registration.
• Ability to work in multiple systems during a telephone call or patient facing interaction to complete an accurate registration and support clinical workflow.
• Responsible for review of services being rendered to ensure the appropriate setting of care has been assigned by the physician's office; if not, physician staff will be advised of the contractual or regulatory expectation warranting a change of setting of care. For example : Inpatient to Outpatient or Inpatient Only requirement
• Ability to respond to requests for estimates for service being rendered or expected to be rendered
• Contact patient if issues or data missing impeding ability to financially secure encounter.
• Responsible for securing encounters with extremely tight timeframes due to late booking of service

Qualifications :

Thank you for your interest in Albany Medical Center! Albany Medical Center is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that : Access to information is based on a "need to know" and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.