AMVETS Jobs

This job was posted by https://www.azjobconnection.gov : For more information, please see: https://www.azjobconnection.gov/jobs/6464864

Overview:

The Patient Access Admissions Counselor is responsible for the verification and collection of patient demographic and insurance information by direct data entry to the electronic medical record during the scheduling/pre-admit or admission process prior to discharge. Performs verification of insurance benefits, documents current coverage and eligibility details, and completes timely notifications for required authorization of services. Ensures authorization for surgical/special interventional procedures and inpatient/observation hospital stays is secured with appropriate system documentation. Provides financial education and counseling to the patient related to insurance coverage, financial liability, and investigates avenues for alternate payer source or eligibility for financial assistance. Acts as an expert knowledge resource for clinical areas, Nursing Units or Care Management related to registration and financial counseling questions or issues.

Responsibilities:

Patient Registration/Scheduling\

• Demonstrates high degree of proficiency in computer skills and Microsoft applications; includes navigation of web-based or system applications required for Patient Access Services with keyboarding of 50+ wpm.

• Accurate identification of patient for direct data entry of required clinical, demographic, and insurance information to the electronic medical record during registration or for appointment booking of assigned procedures.

• Provides detailed explanation of scheduled procedures and patient instructions that are associated to the medical service.
• Ensures system documentation specific to the patient visit is entered and accurately reflects activities related to patient or provider contact, order documentation, insurance verification, financial education, and payment.
• Provides explanation of legal forms and secures signature of patient/authorized party as required for services.
• Performs medical necessity checking for identified services; secures required ABN documentation as appropriate.
• Demonstrates thorough understanding of compliance standards required within a healthcare environment including EMTALA and HIPAA-Privacy Patient Confidentiality regulations.

\ Insurance Verification for Eligibility/Authorization\

• Accurate identification and selection of insurance carrier in the patient medical record for specified dates of medical services

• Navigates web-based products or system applications to initiate and document insurance eligibility, benefit details, authorization requirements.

• Performs required notifications to ensure insurance authorization for identified medical services, including surgical/special interventional procedures and inpatient/observation stays, are secured and documented.
• Demonstrates advanced knowledge of CPT, ICD10 coding, and physician order documentation as required for medical services including determinations for medical necessity.

\ Financial Counseling\

• Demonstrates expert knowledge of regulatory or Third Party Payer insurance requirements including Medicare, AHCCCS/Medicaid, Workers Comp and other commercial payers.

• Educates the patient on insurance eligibility, coverage, procedure costs, alternate resources for financial assistance, and payment arrangement guidelines.

• Uses professional negotiation techniques to collect identified patient financial liabilities; performs secured payment entry and deposit/cash reconciliation steps.
• Navigates web based products to initiate, document, and provide charge estimation for In patient/Observation stays, Surgical/Special Interventional procedures or service categories based on patient requests or financial counseling needs.
• Demonstrates advanced conflict resolution skills to address issues related to scheduling, registration or the financial assistance application approval process.
• Makes direct contact on behalf of the patient to providers, insurance representatives, or outside agencies such as Arizona Department of Economic Security to initiate and monitor success of AHCCCS application process.
• Monitors system work lists to provide necessary financial counseling follow-up for private pay patients in the Emergency Department and Inpatient/Observation settings. Ensures patient account is updated to reflect new payer source(s).

\ Revenue Cycle Support for Hospital or Clinical Services\

• Handles department call volumes as assigned to appropriately respond to requests from patients, providers, or other hospital departments.

Acts as an expert resource to clinical departments for registration/scheduled services related to data entry of patient account fields, provider order requirements, and questions regarding insurance coverage or financial assistance.

Coordinates information with Nursing Units or Care Management related to registrati