NHRMC, established in 1967 in Wilmington, NC, is recognized as a preeminent healthcare organization focused on leading our community to outstanding health. We have an 855 bed network of hospitals and multi-specialty physician group practices with more than 200 physicians. With a network of primary, specialty, neighborhood clinics and regional medical centers; you will find our culture is the very definition of best in practice. Join us and find out how many ways NHRMC offers you the chance to focus on what really matters - our patients and community.
About the Job
Location: NHRMC Business Center A
Department: Financial Clearance
Full Time Equivalent: FTE: 0.600000
Work Type: 48 to 63 Hours Pay Period
Work Schedule: ENTERSCHED - Please Select Schedule!
Exempt from Overtime: Exempt: No
What You'll Do
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.
This position description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications which may be required of the employee assigned to the position. Depending on the location of the job, duties may vary. Receipt of the job description does not imply nor create a promise of employment, nor an employment contract of any kind; my employment with the Company is at will.
- Member Top 100 Hospitals – In 2016 NHRMC was recognized as a Top 100 Hospital demonstrating significant investment and financial sustainability for the communities we serve.
- Newsweek's 2020 list of Best Maternity Care Hospitals - NHRMC Betty H. Cameron Women's & Children's Hospital was named as a Best Maternity Care Hospital by Newsweek.
- Forbes America’s Best Large Employers 2018 and 2019- Link
- Becker’s 150 Top Places to Work in Healthcare- Link
- Healthgrades Outstanding Patient Experience
Consider a career at NHRMC and become part of this award winning team!