What are the responsibilities and job description for the Patient Access and Health Information Management Specialist position at Mount Evans Home Health Care & Hospice?
Company Overview
Mount Evans Home Health Care & Hospice is dedicated to providing compassionate in-home health care and hospice services to residents in the Colorado mountain area. Our mission includes offering essential grief support to both adults and children, highlighted by our award-winning children’s bereavement program, Camp Comfort.
Summary
The Patient Access and HIM Specialist is responsible for managing patient eligibility verification, obtaining prior authorizations for services, and maintaining accurate medical records in compliance with healthcare regulations. This role involves coordination with insurance providers, healthcare teams, and patients to ensure seamless service delivery and ensure timely resolution of access and HIM issues impacting billing and reimbursement.
Essential Functions
Intake:
- Responsible for managing the patient intake process including but not limited to referral portal utilization, accurate data entry of all referrals into the EMR, ensuring all admission paperwork has been received and uploaded in the EMR.
- Serves as the initial point of contact for patients and referral sources to facility a smooth admissions process from initial contact to service delivery.
- Coordinates with clinical staff to ensure and communicate timely scheduling.
Eligibility Verification:
- Verify patient eligibility for home health services using insurance guidelines.
- Communicate with insurance providers and billing partners to resolve coverage issues.
- Communicate with patients regarding potential financial responsibility based on plan provisions.
- Maintain accurate documentation of eligibility checks.
Authorization Coordination:
- Obtain initial and ongoing authorizations for home health services, medications, and procedures.
- Ensure timely submission of authorization requests to insurance providers.
- Track and follow up on pending authorizations to avoid delays in service delivery.
- Collaborate with clinical staff to ensure proper coding (e.g., CPT, ICD-10) for authorization requests.
Medical Records Management:
- Maintain patient medical records in compliance with HIPAA regulations.
- Retrieve, organize, and file medical records (both paper and electronic).
- Process requests for records from patients, families, law offices, or insurance companies.
- Responsible for sending and receiving signed orders from physicians in a timely manner.
- Implement standards for record retention and disposal as per legal requirements.
Administrative Duties:
- Input data into electronic systems for tracking authorizations and medical records.
- Respond to inquiries from patients, providers, or external entities regarding medical records or authorizations.
- Prepare reports on authorization status and medical record compliance.
- Support intake as a back up and assist RCM manager with special projects as needed.
Requirements
- Ability to consistently promote, support, work, and act in a manner in support of the Mount Evans mission and values.
- Strong organizational, time management and problem-solving skills.
- Excellent written and verbal communication abilities.
- Detail-oriented with strong organizational skills and the ability to manage multiple priorities.
- Proficiency in Microsoft Office Suite and in data entry and use of electronic health record (EHR) systems.
- Ability to work under tight deadlines and handle sensitive information with discretion and professionalism
- Ability to work independently and collaboratively in a team-oriented environment.
If you are passionate about making a difference in the lives of patients and their families, we invite you to apply for the Patient Access Specialist position at Mount Evans Home Health Care & Hospice today!
Job Type: Full-time
Pay: $22.00 - $28.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Ability to Commute:
- Evergreen, CO 80439 (Required)
Ability to Relocate:
- Evergreen, CO 80439: Relocate before starting work (Required)
Work Location: In person
Salary : $22 - $28
