Medical Assistant/Nursing Assistant Patient Access Specialist 

Job Summary

Reporting to the Revenue Cycle Manager and/or their designee, the Medical Assistant/Patient Access Specialist is responsible for confirming patient demographic and insurance information to ensure accurate billing for services provided by Total Health Care (THC). To accomplish this, the MA/PAS must enter all necessary information into Total Health Care's (THC) Electronic Medical Record (EMR) systems for mental health or substance abuse. The MA/PAS identifies patients in need of financial assistance and assist them per THC policies and procedures.

Contacts and interactions vary and may involve multiple constituencies such as direct interaction with THC’s executive management, community organizers, the general public, THC’s patients, physicians, colleagues, assigned staff, vendors, Medical Insurance companies (Payers)/Managed Care Organizations (MCOs) contractors and consultants for the purpose of providing and exchanging information.

Example of Essential Job Functions:

The Medical Assistant/Patient Access Specialist 

(MA)/Certified Medical Assistant (CMA) or C NA) are responsible

for performing physician support services that help ensure that

the medical centers run efficiently. The Total Health Care MA/CMA/CNA

is an integral member of the healthcare team and is recognized as being one of the

first clinical staff to engage with a patient during a provider visit. The tone

set for the visit by the MA/CMA/ CNA can contribute to the overall impression of the

clinic and influence how the patient engages with the care team.

General responsibilities for all medical assistants may include both administrative as

well as clinical duties. Administrative duties involve collecting demographic

and payment information from Total Health Care’s (THC) patients at point of

service, verifying and entering insurance information into THC’s Electronic

Medical Records (EMR) systems CESH and substance abuse,

patient registration, scheduling appointments, processing encounters, and

assisting with the reduction of unnecessary write-offs and negative adjustments

for uncollectible charges. Clinical activities include performing necessary

clinical assessments such as vital signs and POC testing, giving injections,

performing EKG’s, assisting with procedures, and documenting clinical

activities in accordance with governmental and institutional guidelines and

protocols. 

Example of Essential Job Functions Medical Assistant (MA, CMA or CNA) 

• Completes vital signs and other clinical measures

as ordered (i.e, diagnostic testing such as EKG, vision/hearing screening etc.)

to ensure patient readiness for provider. 

• Collects patient information using SOAP/SOAPIE

FORMAT and assists patients with completion of forms.

• Documents all information accurately and

comprehensively in the EMR. 

• Performs pre-registration by verifying insurance coverage and documenting accurate

responsible third party information to ensure maximum reimbursement. 

• Registers patients which includes scanning the front and back of

all insurance/ identification cards and manually entering insurance, demographic,

and other relevant information in the EMR. 

• Stocks rooms and maintains a neat, clean,

organized, and safe clinical environment. 

• Participates

in all QI activities. 

• Completes

the patient visit by providing discharge paperwork and scheduling patient follow

up appointments.

• Answer

phones, direct calls accordingly and/or assist with phone requests. 

• Performs clerical activities such as scheduling

referrals and mailing letters.

• Behaves in accordance with THC’s customer

service standards to promote patient satisfaction which includes greeting all patients

and/or visitors.

• Adheres

to OSHA, HIPAA, and other related guidelines. 

• Other

duties as assigned.

•Completes insurance verification (EVS) on all patients scheduled to be seen at any THC site or department (IBH, CESH/Substance Abuse). 

•Confirms and enters patient’s current insurance status in the Practice Management System (PMS) at the time of check in.

•Communicates co-pay or payment requirements at time of service. 

•Collects payments, co-payments as well as deductibles at point of service and post receipts accordingly.

•Completes daily self-pay log for self-pay patients and obtains appropriate sign-off from Patient Access Supervisor. 

•Reconciles receipts and prepare point of service collections for bank deposit.

•Adheres to company procedures for keeping of cash secure

•Confirms that THC is listed as the facility providing care for the patient and ensuring that the specific THC Primary Care Provider is entered in the PMS.

•Confirms authorizations are secured for CESH and Substance Abuse departments for current and upcoming visits.

•Obtains secondary QMB cards for qualified patients.

•Completes Medicare Secondary Payer questionnaire for appropriate coordination of benefits. 

•Assists with meeting department goals and department KPIs measures while maintaining integrity.

•Follows up with patient to clarify benefits and correct coordination of benefit issues.

•Provides financial counseling and providing information about the Maryland Health Connection, including eligibility requirements for applicable federal premium subsidies and cost-sharing assistance. 

•Facilitate enrollment into Medicaid, MCHP, or a Qualified Health Plan.

•Provides referrals to appropriate agencies including the Attorney General’s Health Education and Advocacy Unit (HEAU) and the Maryland Insurance Administration (MIA), for applicants and enrollees with grievances, complaints, questions or the need for other social services.

•Scans front and back of patients' insurance/identification cards so they can be uploaded to the EMR.

•Completes the primary care provider change form if provider information is not valid and submits it via secure fax and obtain fax confirmation receipt on the day of the visit.

•Assists patients with completion of the Intake/Consent forms and OMS

•Obtains all necessary signatures and documentation required by the patients' insurance plan. 

•Determines the appropriate financial class and/or account type and correctly assign primary and secondary insurance billing status when two insurance plans require coordination of benefits.

•Determines eligibility of patients for 30 day/6 month sliding fee scale

•Monitors 6 month sliding fee patients for appropriateness and to determine insurance eligibility status.

•Tracks Department of Social Services vouchers and other third party/community payer documentation as well as medical form and submit to Revenue Cycle Manager for billing. 

•Other duties as assigned.

Minimum Education, Training and Experience Required

High School diploma or equivalent (post High School education preferred) and/or any combination of education, training and experience providing understanding of the field and the ability to perform the essential functions of the job. Two years hospital or physician practice patient registration, customer service, insurance verification, financial clearance, or billing and ICD-9 medical coding experience in a healthcare environment.

Medical Assistant/ Certified as a Medical Assistant or Certified Nursing Assistant Required

Certification as a Certified Healthcare Access Associate CHAA (NAHAM) preferred but not required

COVID Vaccination Required: 

The Maryland Department of Health issued a directive effective Wednesday, September 1, 2021, employees required to show proof of [a] first dose or single dose of COVID-19 vaccination.” This mandate makes the requirements effective for every healthcare system in the state.