What are the responsibilities and job description for the Patient Access Advocate I position at Presbyterian System Services?
Location Address:
4100 High Resort Blvd SE Rio Rancho, NM 87124-5901Compensation Pay Range:
Minimum Offer $15.58 Maximum Offer $21.19 Now Hiring: Patient Access Advocate ISummary:
Job Description SummaryThe Patient Access Advocate I provides primary registration of patient accounts for self-pay, government and commercial accounts on date of service for scheduled and unscheduled visits. Perform registration functions, including updating of demographics, insurance verification, collection of point of service liabilities and documentation of registration information within the ADT system. Confirm account being registered has accurate information to ensure clean billing. Must possess basic knowledge of Medicare (CMS) guidelines, as well as other Compliance Regulatory guidelines applicable to Patient Access. Type of Opportunity: Full time Job Exempt: No Job is based: PMG - Rio Rancho High Resort 4100 Work Shift: Days (United States of America)
Responsibilities:
As a Patient Access Advocate for Rust Medical Center, you will be helping with registration and appointments are coordinated , below are the key responsibilities.
Customer Service and Caring Practices:
Ability to provide exceptional patient experience for patients and patient families by using CARES, AIDET and EPE tools.
Addresses and attempts to appropriately resolve complaints in the moment by using key words at key times and de-escalation processes.
Ability to manage conflict and appropriately request the help of a supervisor when needed.
Implement PROMISE and CARES behaviors in every encounter.
Educates patients for whom they speak regarding insurance benefits and liabilities.
Encounter Components:
Performs the patient registration process. Manage the accurate collection of patient data which includes but is not limited to;
Obtain/confirm and enter demographic and other financial information, not obtained during pre-registration/financial clearance process, necessary for account completion.
Obtain missing insurance information, to include policy number, group number, date of birth, and insurance phone number if not already identified in account.
Verify insurance for eligibility and benefits using online electronic verification system or by contacting payer directly.
Accurately document actions taken in the system of record to drive effective follow-up and ensure an accurate audit trail.
Maintain ongoing knowledge of authorization requirements and payer guidelines. Maintain a knowledge of Medicare (CMS) guidelines as it relates to admissions and outpatient services. Ensuring compliance with admissions forms, benefit entitlement verification, and billing requirements.
Ensure accurate completion of MSPQ at time of service if not completed during financial clearance process.
Daily focus on attaining productivity standards.
Monitor and track Data Quality program to ensure errors are corrected at time of service. .
Maintain appropriate records, files, and timely and accurate documentation in the system of record.
Financial Accountabilities:
Collects identified patient financial obligation amounts including residual balance if applicable. Collect liability from patient at time of service.
Educate patients on financial assistance, charity or other programs that may be available.
Refers as appropriate to on site Financial Advocate or to the Financial Advocacy Center
Patient Relations:
Complete any information missing from the account to ensure accuracy at time of visit.
Transparency with patients through communication of patient liabilities..
Quality Improvement:
Qualifications:
High school diploma/GED
6 months experience in healthcare setting or 1 year customer service background.
Pass 2 week Patient Access Academy with a passing score of 85% or higher (within 6 mos of start).
CHAA, CHAM or other industry equivalent certification preferred
Basic understanding of insurance preferred.
Basic understanding of medical terminology and billing codes (DRG, ICD-10, CPT, HCPCS) preferred
Requires basic understanding of registration and healthcare.
All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services
Salary : $16 - $21