Pre-Access

Specialist is responsible for one of the first impressions a patient will have

of Billings Clinic. Incumbent will provide education both verbally and via mail

in an effort to manage the patient and/or family member’s expectations as a

patient of our facility. New and some established patients for both clinic and

hospital services will be contacted to obtain all patient and guarantor

information, insurance information including any information related to

accident insurance, etc. as well as additional contact information. All

regulatory requirements as to determination of primary and secondary carrier

status will be collected. Staff will inform patient/family member of insurance

billing processes as well as payment expectations. Payment policies will be

reviewed as well as any need for co-payment and/or coinsurance/deposit

requirements. An explanation of what the patient can expect at check-in will be

provided as well as information regarding parking, valet services, etc.

Patients will be provided with a customized new patient welcome packet

including their scheduling itinerary and way finding materials. Through the

conversations during registration and demographic information collection, staff

will provide patients with information regarding the need to contact Financial

Representatives in reference to financial assistance and/or payment

arrangements. Addresses will be verified electronically by staff members.

Essential Job Functions

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Supports and models behaviors consistent with Billings Clinic’s mission,

vision, values, code of business conduct and service expectations. Meets all

mandatory organizational and departmental requirements. Maintains competency in

all organizational, departmental and outside agency standards as it relates to

the environment, employee, patient safety or job performance

• Provides first impression of Billings Clinic to patients and family members.

Focus on patient service is first and foremost.

• Validates insurance entries using Intellisource software, commercial web

site, or calling insurance company and analyzes electronic/verbal responses

ensuring appropriate set-ups dependent upon State where services are being

rendered

• Coordinates with patients, internal and external providers, nursing staff to

ensure Medicaid Passport and other authorizations for referrals required by

insurance carriers are obtained and entered onto specifically approved

encounters within the revenue cycle system.

• Schedules and coordinates appointments in a manner that meets the patient’s

needs and is in keeping with each individual provider’s scheduling protocols

for the various appointment types, lengths of appointments and any

pre-appointment requirements as outlined by the providers.

• Review and analyzes AccuReg edits completes corrections in accordance with

AccuReg worklist daily.

• Consistently uses searching techniques within the Registration system to

identify existing Billings Clinic health information record for additional

updating.

• Accurately obtains all patient, guarantors, primary, secondary and tertiary

insurance information from patients and verifies patient/guarantor primary

residence address as well as insurance eligibility and co-pay requirements

on-line. If unavailable on-line, contact insurance carrier via phone to verify

all information. Familiarizes self in various insurance cards and

identification to assist patient in providing accurate information.

• Participates in quarterly assessments in accordance with policies and

procedures.

• Reviews, analyzes and interprets information obtained to determine regulatory

requirements that may exist including completion of MSPs, gathering of third

party payors in relation to accidents, etc. Maintains this knowledge for both a

clinic and hospital setting.

• Uses processes and information to manage a patient’s expectations for

parking, check-in process, way finding, insurance billing turnaround times,

etc. Prints patient’s custom schedule itinerary, way finding tools and

department specific information along with new patient welcome packet (if

needed) and mails to patient.

• Discusses Billings Clinic expectations for payment of services by supplying

patient with verbal explanation of our payment policies to include co-pays,

coinsurances, and/or deposits to be made at the time of service in conjunction

with Billings Clinic policies and procedures.

• Provides assistance in ensuring patients are directed to the appropriate

resources within the organization if questions arise as to the patient’s

ability to pay. Provides patients with financial assistance applications if

appropriate.

• Ensures all work lists are completed within guidelines and provides

appropriate hand-off information to others to ensure all patients are

contacted.

Performs other duties as assigned or needed to meet the needs of the department/organization.