Patient Account Specialist I

Where compassion meets innovation and technology and our employees are family.

Thank you for your interest in joining our team! Please review the job information below.

GENERALPURPOSE OFJOB:

This position reports to the department manager. This position is responsible for the creation ofthe patient account in the EMR patient accounting system in support of patient care departmentsand in support of the revenue, billing, and reporting cycle to also secure reimbursement. Thisincludes but is not limited to functions under the categories of patient accounting, referral orderrecord management, patient scheduling, pre-registration/registration or pre-admission,
admission, verification of patients’ benefits, gather & document insurance benefit details,authorization procurement as required by payer policy, creating estimate of cost, documentationof the authorization and/or referral order record, obtaining consent signatures, granting MyChartor MyChart non-patient proxy account access, documentation of actions taken and of patientfinancial discharge task. This role serves as a key promoter of service excellence which, alongwith the team, strives to meet and exceed the needs of their customers.

Essential Duties and Responsibilities:

To perform this job successfully, an individual must be able to perform each essential dutysatisfactorily to achieve clean claim processing. The requirements listed below are representativeof the knowledge, skill, and/or ability required. Reasonable accommodation may be made toenable individuals with disabilities to perform the essential functions. This job description is not
intended to be all-inclusive; employees will perform other reasonably related business duties asassigned by the immediate supervisor and/or hospital administration as required.
•Always maintains utmost level of confidentiality.
•Adheres to hospital policies and procedures.
•Demonstrates business practices and personal actions that are ethical and adhere to corporatecompliance and integrity guidelines.

•Adheres and comply with customer service standards and dress code as set forth by thehospital and the department.
•May be required to work rotating shifts.
•This position is an essential role and may be part of the disaster plan A or B team duringdisaster events.
•Occasional travel may be required

Customer Service Duties– utilizing the Driscoll Way to Service Excellence
•Answers the department telephone immediately or within three rings utilizing courtesy andpatience
•Greet patients and their families with courtesy and concern for their needs using the DriscollWay to Service Excellence
•Listens to customer needs and takes appropriate action as indicated.
•Work cooperatively with all levels of staffing and care settings to accomplish

desired careoutcomes.

Patient Accounting Duties
The Patient Account Specialist will process patient accounts according to establishedworkflow designs.

Work cooperatively with DAC [Driscoll Access Center] staff to process expected ED admissions, direct admissions, and transfers and create CCT or HBRT encounters as indicated.
Process provider orders for care; search for referral order first, if not found, createreferral record.
Accurately create patient record and or encounter in patient accounting systems utilizingthe appropriate patient search criteria, using the established naming convention, andinterview method while being open and transparent with customers.
Gather patient demographic and financial information in a kind and courteous manner.
Verify patient’s insurance benefit and document findings, this process should be
completed in the appropriate timeframe for the service being provided; refer to
Emergency Medical Treatment and Labor Act -EMTALA guidelines for ED arrivals/services
Follow payer requirements for payer authorization procurement workflows and
admission notification.
Schedule patients for necessary procedures as indicated, using the appropriate schedulingsystem and obtain authorization for all planned services as indicted by insurance carrier.
Request and follow cases for required questionnaires & documents such as H&P, PCPReferral, CPS Consents.
Complete an emergency visit arrival event in a timely manner.
Reschedule patients upon patient request and notify the patient’s physician.
Add notes to each encounter in patient account notes as indicated, brief but importantdetails only
Manage an appointment waiting list and canceled list as indicated to ensure services areprovided promptly
Refer cases for financial screening as necessary.
Add a clear copy of picture identification and insurance cards, front and back to thepatients Electronic Medical Record - EMR
Explain all business forms and obtain signatures

Issue Patient Rights and Responsibilities and the hospital’s Notice of Privacy Practice asindicated.
Issue patient identification card or wristband identification as appropriate.
Ensure the patient/family is escort to the appropriate service area.
Contact the Patient Intake Nurse for all direct admissions as indicated.
Manage admissions to the various service areas as directed.
Follow discharge workflows as directed by service area.
Manage visitor volume at Welcome desks or in the admitting office daily as indicated.

Quality Assurance Duties
•Review & manage work queues to identify potential duplicate referrals numbers, HARs, ormedical record numbers.
•Review & manage patient accounting work queues by area to address missing reg items perencounter.
•Review & manage patient demographic and financial data for accuracy.
 

Patient Financial Discharge Duties

•Review documented notes for payment requirements; explain insurance benefits as quoted tous by their insurance carrier, provide an estimate of charges and explain billing workflow.
•Refer cases for financial screening as indicated.
•Prepare hospital receipt for payment received.
•Validates name, address, and phone number, to ensure you are in the correct record & updateas needed.
•Ensures all paperwork is complete and all insurance cards and identification cards are copiedfor business record.
•Document all actions taken at discharge in patient accounting system.
Cashiering Duties
•The department’s petty cash will always be in balance.
•Payments received will always be receipted and reconciled, daily per shift.
•The department Standard Operating Procedure for cash handling will be followed.

Education and/or Experience:
High school diploma or general education degree (GED) required; and one-year relatedexperience and/or training preferred