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Pre-Access Specialist


Pay: TBD

Full Job Description
 

Overview:

Position is remote/work from home within the UnityPoint Health regions. Monday – Friday days, 30 hours per week.
 

 

Performs pre-registrations for scheduled accounts for multiple UnityPoint Health affiliates via contact with patients, physicians or appropriate information sources. Obtains insurance eligibility, benefits for inpatient and outpatient, scheduled and nonscheduled visits. Updates demographic and insurance information in system as needed. Initiates collection process by creating and mailing estimates, contacting patients/representatives about date of service deductibles, coinsurance and copayments. Establishes financial arrangements with patients according to policy. Primary documentation source for access and billing staff.

Responsibilities:

Pre-Registration
  • Obtains daily work through systems’ work queues and reports as assigned by supervisor.
  • Completes eligibility check and obtain benefits though electronic means or via phone contact with insurance carriers or other agencies.
  • Contacts patients/families/physicians to obtain additional demographic/insurance information and update in computer system if needed in order to proceed with verification process.
  • Demonstrates subject matter expertise with insurance requirements across multiple affiliates.
  • Accurately and thoroughly collects, analyzes and records demographic, insurance/financial and clinical data in computer system. Ensures information source is appropriate.
  • Explain benefits and request copay, coinsurance and portion of deductible.
  • Follows department policy for payment or nonpayment responses.
  • Requests patient to bring required documents on day of service, i.e., physician orders, insurance cards, claim forms, liability information, photo ID, etc.
  • Documents in system the need for front-end Patient Access Associate to collect at time of service any copay or deductible that could not be collected during the preregistration process.
  • Identifies patients in financial hardship and refer to Patient Financial Coordinators for charity/financial assistance.
  • Refers to Cash Posting Specialists any patients requiring payment plans.
  • Completes registration checklist.
  • Documents on accounts using hospital account note with activity comments to ensure easy account follow up.
  • Follows EMTALA, HIPAA, payer and other regulations and standards.
  • Other duties as assigned
Customer Service
  • Adheres to department customer service standards.
  • Demonstrate the FOCUS values to provide the best customer services to patients, customers, vendors, and team members.
  • Acts willing and ready to assist department personnel with their duties as time permits or need arises.
  • Readily identifies work that needs to be performed and completes it without needing to be told

Qualifications:

Education:
  • Requires minimally a High school diploma or GED.
  • Two years of experience in a hospital patient access/patient accounts department, medical office/clinic or insurance company is desired/preferred.
Experience:
  • Previous customer service experience.
  • Experience interacting with patients and a working knowledge of third party payers and collections is preferred.
  • Prior experience with verification, and payer benefit and eligibility systems is preferred.
Knowledge/Skills/Abilities:
  • Ability to perform a variety of tasks, often changing assignments on short notice.
  • Must be adept at multi-tasking
  • Will be required to learn and work with multiple software/hardware products (sometimes concurrently) during an average workday
  • Must possess excellent communication skills, verbal and listening.
  • Must be able to maintain a professional demeanor in stressful situations.
  • Adept with technology typically found in a business office environment.
  • Mathematical aptitude to make contractual calculations and estimate patient financial obligations.
  • Able to build productive relationships with all contacts.
  • Must be able to perform data entry with speed and accuracy
  • Knowledge of Medical Terminology is preferred.

Company – Unity Point Health