Under the direction of the Patient Access Supervisor, reviews reports, registrations, and admissions for appropriate demographic and insurance information to ensure that accounts are complete, accurate, and insurance billable.
Maintains audit process to include type of error, payer source, service line, and associate. Ensure corrections are performed prior to billing.
Communicates audit finding with Patient Access Associates, Patient Access Team Lead and Management. Provides training recommendations and measures process improvement.
Creates and delivers monthly reports spreadsheets and graphs to identify training needs. Manages TCE and CM1 records to ensure billing criteria is met in a timely manner.
Reviews Outpatient Exception and Alpha Discharge reports and communicates trending patterns to Patient Access Team Lead, Patient Access Supervisor and Patient Access Manager.
Required Skills
- Ability to deal tactfully with Employees, patients, visitors and the general public.
- Basic computer literacy and keyboarding skills required.
- Effective written and verbal communication skills required.
- Analytical and problem-solving skills required.
- Knowledge of commercial and managed care payers and terminology.
- Bilingual English / Spanish required.
Required Experience
Work Experience :
Two years office and / or customer service experience required with knowledge of basic office equipment and computer software programs.
Healthcare or financial background preferred.
Education and Training :
- High school diploma or equivalent.
- Training or educational background with medical terminology and familiarity with ICD coding preferred.
- Ability to deal tactfully with Employees, patients, visitors and the general public.
- Basic computer literacy and keyboarding skills required.
- Effective written and verbal communication skills required.
- Analytical and problem-solving skills required.
- Knowledge of commercial and managed care payers and terminology.
- Bilingual English / Spanish required.
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