The Account Specialist will provide patient services and administrative support in clinic operations, and interact with parents, patients, physicians and other staff under moderate supervision. Responsible to obtain and validate patient information from various sources and to ensure information entered into the computer management system is accurate. Perform the registration process for all inpatient and outpatients and obtain required forms and signatures. Will complete all managed care notification requirements and contact various payers to obtain pre-certification, co-pay and deductible information. (Will notify patient that a co-pay or deductible is required.)
Qualifications:
Minimum Education
High School Diploma or GED (Required)
Minimum Work Experience
2 years 2 to 3 years of related experience. Experience performing billing, patient registration, and scheduling, medical insurance verification, insurance screening and charge posting. (Required)
Required Skills/Knowledge
Broad clinic knowledge, customer service skills, experience in health care setting preferred. Computer knowledge necessary.
Functional Accountabilities
Technical Responsibilities

• Secure all self pay admissions and those with questionable insurance coverage daily.

• Interview guarantors/patients and refer accounts to deco/medlaw to complete a financial application to determine his/her financial ability to pay consistent with the philosophy of the Hospital; update chart and notify insurance company when notification of additional insurance is validated. (I.e. Deco/Medlaw/UM notification).

• Work a minimum of 35 accounts daily; notate all accounts within 24 hours of admission; discharge report will not have more than 3 accounts pending authorization.

• Utilize the HBOC/Star System to obtain vital patient and insurance information, make changes to the patient's record, and understand functionality of screens.

• Utilize the PPM system to update insurance information and understand the functionality of screens.

• Perform as a registrar when requested.

• Inform the UM department and Patient Unit if the insurance is updated or changed during the course of the day .

Departmental Relations

• Assist in the improvement of overall department by participating in committees, department meetings, and to provide ideas to Management to improve efficiency , productivity and cash flow; attend 75% of Departmental Meetings.

• Document customer inquiries, interviews, third party conversations, and any additional information obtained; meet the needs and

• expectations of our Customers.

• Handle Customers, Third Party Payers and Hospital Associates in a professional and tactful manner.

• Respond to inquires from physicians, and outside organizations (I.e. Deco/Medlaw/UM).

Professional Development

• Participate in Hospital and Departmental performance improvement activities.

• Maintain job-specific and department specific certifications and competencies.

• Maintain current job related knowledge and seek opportunities to advance that knowledge through continuing education, seminars, workshops, cross training, and other educational offerings.

• Review all office communications, emails and information posted on department bulletin boards to keep abreast of important news and policy and procedures.

• Adapt to frequent changes in technology and operating policies and procedures.

• Take initiative to cross-train for advancement within the Patient Access Department.

Leadership

• Help associates with orientation, to improve their performance, to cross-train and to reach team goals.

• Manage material resources effectively and efficiently .

• Performs related duties of assigned staff as required; handle special projects as assigned by Management

Non-Essential Function

• Personal telephone calls and idle conversation kept to a minimum with no disruption of work flow of others, or misuse of quality work time.

• Maintain Attendance and Punctuality

Organizational Accountabilities
Organizational Accountabilities (Staff)
Organizational Commitment/Identification

• Anticipate and responds to customer needs; follows up until needs are met

Teamwork/Communication

• Demonstrate collaborative and respectful behavior

• Partner with all team members to achieve goals

• Receptive to others' ideas and opinions

Performance Improvement/Problem-solving

• Contribute to a positive work environment

• Demonstrate flexibility and willingness to change

• Identify opportunities to improve clinical and administrative processes

• Make appropriate decisions, using sound judgment

Cost Management/Financial Responsibility

• Use resources efficiently

• Search for less costly ways of doing things

Safety

• Speak up when team members appear to exhibit unsafe behavior or performance

• Continuously validate and verify information needed for decision making or documentation

• Stop in the face of uncertainty and takes time to resolve the situation

• Demonstrate accurate, clear and timely verbal and written communication

• Actively promote safety for patients, families, visitors and co-workers

• Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance