Central Access Specialist

Job Summary :

The Central Access Specialist is an entry level position and is responsible for scheduling, securing patient demographic and insurance information; verifying insurance eligibility and benefits, verify pre-certification is obtained and / or validated; computing, communicating and obtaining patient collections and initiating the financial clearance process. Emphasis is scheduling patients greater than 3 to 5 days prior to the scheduled service date. In addition the Central Access Specialist will complete insurance verification / pre-registration and financial clearance for special admissions. Central Access Specialist manages heavy call and schedule volumes. Position is responsible for notifying patients of their financial obligation and collecting co-pays, deductibles, deposits and other identified out-of-pocket liabilities or deposits on accounts as required and supporting their department in meeting the pre-collections goals defined by Revenue Cycle management. This also includes a review of past account balances, notifying patient of additional financial responsibility, and attempt collection of these balances. Review accounts with inadequate financial coverage for the purpose of coordinating with the Central Access Financial Advocate. The Central Access Specialist demonstrates professionalism as reflected by courteous actions, maintenance of confidentiality and appropriate presentation of self; consistently exhibits excellent oral and written communication skills; possess the knowledge and skills necessary to provide interactive communications appropriate to the age of the patient being served; interact appropriately with third party payers and other departments; and have the ability to relate well to people of a broad socio-economic mix. Strong organizational skills, ability to multitask, work in a fast pace environment, manage a multi-line phone system and a commitment to teamwork are essential. Must have ability to work closely in a clinical setting involving some stressful situations,

Education : Required :

High School Diploma or equivalent

Preferred :

Prefer graduate of Medical Secretary Program

Experience : Required :

Demonstrated ability to read, write, arithmetic, multiplication / division including fractions and decimals. Strong computer skills, excellent customer service skills, interpersonal communication and telephone etiquette are required. Demonstrate ability to multitask and manage high volumes. Computer, fax machine, copier, multiline telephone.

Preferred :

Knowledge of basic registration and third party payer preferred. Preference for work experience in a physician front office operations or insurance / healthcare call center. Medical terminology, and basic knowledge base of CPT and ICD-9 codes, insurance coding and billing knowledge,

Position Requirement(s) : License / Certification / Registration

Required :

Preferred :

Certified Healthcare Access Associate from NAHAM

Essential Functions :

1. Answering incoming phone calls and scheduling outpatient

appointments.

2. Pre-register scheduled patients by gathering all patient demographic

and financial information.

3. Verify insurance eligibility and benefits for scheduled outpatient and

inpatient patients.

4. Validate and initiate pre-certification.

5. Compute patient liability.

6. Communicate and initiate time of service collections.

7. Review prior bad debts and request payment of outstanding prior bad

debt.

8. Alert Financial Advocates of accounts with financial clearance issues.

Document patient liability and financial clearance status to ensure

timely processing at the point of service.

9. Complete pre-registration, insurance verification and financial

clearance for special admission and transfer patients.