Patient Access Coordinator

Obtain and verify appropriate personal, demographic and financial information for the purposes of ensuring (1) Quality patient care through proper patient identification and (2) maximal reimbursement for all billable clinical services rendered.  (3) Scanning the appropriate identification documents into OnBase.   Obtain EMTALA notification signature. (4) Notify clinical staff when patients present with critical condition.   (5) Once verified places appropriate insurance information on account.

Responsibilities

Analytical Skills 

Analyze patient accounts; evaluate financial data for establishment of current accounts and documents comments to reflect actions taken regarding accounts to maximize reimbursement.   Maintain knowledge of current HMO/PPO/Medicaid/Medicare/commercial insurance regulations and requirements.  Requires working knowledge of Insurance Plans the Christ Hospital participates in.  Determines all insurance coverage’s as primary, secondary, tertiary, etc.   Completes required MSPQ questionnaires for all appropriate patients.  Obtains and documents clinical referrals from other providers. Coordinates patients in need of financial assistance to pay for present and/or future services to appropriate Financial Counselor.  Collects and deposits according to specified protocols, all required and mandatory insurance co-payments. 

Initiates on-line verification of third party Insurance Carriers and Plan Administrators to verify patient benefits. Evaluates and prepares chart documentation to establish that Medical Necessity guidelines have been met.  Prepares and completes documentation that establishes Medicare Compliance such as Medicare Secondary Payor Questionnaire and Advance Beneficiary Notice.  Documents appropriate data in account doc and guarantor notes.

Clinical Skills

Processes Emergency and Obstetrics by notifying appropriate staff. 

Answers and directs incoming calls from Physician’s office staff, ancillary departments and other facilities.  Answers inquiries concerning hospital policies. 

Compliance Skills 

Obtains signatures for the visit for all revenue cycle documentation. 

Prepares charts, collected forms and photocopies (insurance cards) and  documentation.  Distribute, witness by signature and collect patient advanced directive forms/information; referring patients to appropriate personnel to address specific questions as indicated.  Provides patients with information about their rights and responsibilities and all other duties as assigned. 

Communication/Interpretation Skills

Interviews patients and obtains, verifies and enters into database complete and accurate demographic and financial information.   Assesses and updates information as it relates to each encounter. Determines financial plan and coverage priority.  (Data collected directly impacts financial and clinical systems,) 

Must maintain facility established productivity standards and Patient Accounts Quality Guidelines (i.e. 100% accuracy of 95% of all registrations).