Patient Access Account Specialist - admitting

Presbyterian Healthcare Services Rio Rancho, NM
About Us

Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system of eight hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees.

Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans.

We are part of New Mexico's history – and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.

Job Description

Type of Opportunity: Full Time

FTE: 1.000000

Exempt: No

Work Schedule: Days

Location: Presbyterian Rust Medical Ctr

Education:

High School Diploma or GED

Other information:

High school diploma, continued education preferred.

3 years of work experiences in healthcare setting with 2 years of Patient Access and/or billing plus strong customer service background.

Previous completion and passing of Patient Access Advocate I, II and III Advancement test.

Completion and passing of Patient Access Coordinator Advancement test.

CHAA, CHAM or other industry equivalent certification preferred

Robust knowledge and understanding 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

Requires general knowledge of the customer encounter process which may include scheduling, registration, contract requirements, financial guidelines, and coordination of benefits.

Ability to work independently, self-directed and work with individuals with diverse background.

Ability to act as a role model and knowledge source for other Patient Access employees.

Effective communication skills.

Analytical and problem solving skills

Knowledge in Microsoft Office Products

Pass annual competency exam for all areas of responsibility.

Attend Staff meetings

Attend Employee Forums

Summary:

This position provides all necessary functions to financial clear patient accounts for government and commercial accounts prior to the date of service. Perform all financial clearance functions, including insurance verification, authorization, collection and documentation of patient demographics, benefit analysis, financial counseling, and pre-service collections. Ensure follow up on authorizations for scheduled and Urgent/Emergent procedures and admissions until date of service or discharge for admissions. Must possess a proficient knowledge of Medicare (CMS) guidelines, as well as other Compliance Regulatory guidelines applicable to Patient Access, to include HIPAA, EMTALA and CMS guidelines for MSPQ. Monitor work queues for financial clearance and missing authorizations ensuring a payment source is identified and secured, resulting in a clean claim for billing. Act as the Subject Matter Expert (SME) to all employees within Patient Access and for testing of new or existing software and processes. Is responsible for providing the highest level customer service to patients, ancillary departments, payers and providers when financially clearing accounts. Provide coverage to other areas and hospitals as needed to minimize overtime and guarantee the patients receive services as needed without registration delays. Assist in the shadowing of Patient Access candidates and assist in training new hires upon their completion of the Patient Access Academy

Benefits

Benefits are effective day-one (for .45 FTE and above) and include:

* Competitive salaries

* Full medical, dental and vision insurance

* Flexible spending accounts (FSAs)

* Free wellness programs

* Paid time off (PTO)

* Retirement plans, including matching employer contributions

* Continuing education and career development opportunities

* Life insurance and short/long term disability programs

About New Mexico

New Mexico's unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque's International Balloon Fiesta, Los Alamos' nuclear scientists, Roswell's visitors from outer space, and

Santa Fe's artists, and you get an eclectic mix of people, places and experiences that make this state great.

Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC.

New Mexico offers endless recreational opportunities to explore, and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Similar jobs you might like