Location: Nunnelee Pediatric Specialty Clinic
Department: Nunnelee Peds Specialty Clinic
Full Time Equivalent: FTE: 1.000000
Work Type: 64 to 80 Hours Pay Period
Work Schedule: 8HR DAY - Most of shift btwn 7A-3P
Exempt from Overtime: Exempt: No
Under the general direction of the Manager, the Patient Access Technician is responsible for the accuracy and completion of patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include pre-admit/admit/pre-register/register functions, ensuring all insurance requirements are met prior to patients’ discharge, and pursuing cash collection.
1. Analyze insurance coverage and benefits for service to ensure timely reimbursement, obtaining all PAC and/or authorizations as appropriate.
2. Facilitate payment sources for uninsured patients.
3. Determine if patient’s condition is the result of an accident, performing complete research with law enforcement, employers, etc. to determine the appropriate source of liability/payment.
4. Admit/register/pre-register patients, correcting as necessary all patient demographic and financial data.
5. Resolve insurance claim rejections/denials and remedy expediently.
6. Calculate and collect cash payments appropriately for all patients, ensuring reconciliation of daily cash deposit.
7. Maintain general knowledge of CMS guidelines and third party payers, specifically, Medicare, Medicaid, Commercial insurances, HMO’s, PPO’s, POS, indemnity plans, and Worker’s Compensation, etc.
8. Evaluate diagnoses to ensure compliance with the Local Coverage Determination (LCD).
9. Perform those duties necessary to ensure all accounts are processed accurately and efficiently.
10. Promote and maintain excellence in customer service.
* High School Diploma
Experience: One-year business experience with computer knowledge and data entry preferred, or two (2) years of higher education. Bilingual preferred. Demonstrates standards of performance (ownership, teamwork, communication, compassion) that support patient satisfaction and principles of service excellence.
Performs other duties as assigned.
Individual will possess commensurate combination of education, experience and qualifications.