Patient Access Specialist Sr

INTEGRIS Health, Oklahoma's largest not-for-profit health system has a great opportunity for a Patient Access Specialist Sr in Oklahoma City, OK. In this position, you'll work with our Access Center team providing exceptional care to those who have entrusted INTEGRIS Health with their healthcare needs. If our mission of partnering with people to live healthier lives speaks to you, apply today and learn more about our recently enhanced benefits package for all eligible caregivers such as, front loaded PTO, 100% INTEGRIS Health paid short term disability, increased retirement match, and paid family leave. We invite you to join us as we strive to be The Most Trusted Partner for Health.

The Patient Access Specialist Sr. is responsible for the provision of patient access activity for ancillary, diagnostic, surgical and emergency services as assigned to facilitate efficient operations, expeditious reimbursement and optimal customer satisfaction and employee satisfaction. Acts as a liaison between INTEGRIS and patients, providers, and payers for all pre-care matters related to account resolution. Provides information regarding the patient's coverage eligibility and benefits, patient's financial liability, INTEGRIS Health's billing practices and policies.

Assists patients in understanding coverage benefits and coverage terminology. INTEGRIS is an Equal Opportunity/Affirmative Action Employer. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.

The Patient Access Specialist Sr. responsibilities include, but are not limited to, the following:

• Ensures the appropriateness of complex registration activity including scheduling, verifying patient demographic information, processing point of service payments, obtaining signatures for required consent paperwork, document imaging and following documentation standards to facilitate efficient patient access according to assigned protocol
• Ensures the appropriateness of complex patient access transactions including coverage eligibility, insurance verification, patient portion calculation and authorization requirement activity utilizing available systems and resources according to assigned protocol.
• Possesses the ability to use analytical thinking, independent judgment, and clinical knowledge to adjust service area schedules and accommodate special requests from internal and external customers.
• Accepts inbound phone calls from patients, physician offices, insurance carriers, etc. with the intent to resolve the concern immediately.
• Collects patient payments and follows levels of authority to ensure financial clearance.
• Documents all patient accounts activities concisely, including authorization and patient liability requirements.
• Performs filing, data entry, and other duties as assigned.
• Responds promptly to patient inquiries regarding pre-care services, policies, coverage, benefits and financial liability.
• Utilizes multiple resources to resolve patient or payor inquiries while on the phone or preparing/reviewing patient accounts or prior authorization requirements.
• Understands different payer regulations and can communicate effectively with patients regarding their coverage benefits and financial liability.
• Acts as a liaison to resolve complex patient access and account issues, responds to questions on reimbursement and serves as a resource and systems expert for patient access specialists, including on-the-job training, and for performance improvement and appropriateness of complex patient access transactions.
• Provides guidance, feedback and training to staff on multiple processes, payers and systems, and monitors assignments and assess productivity.
• Handles all communication effectively, including telephone, email, and verbally with all departments and caregivers within the health system.
• Initiates and coordinates the implementation of team-oriented process improvement initiatives for the department and organization.
• Initiates and coordinates continuous quality improvement efforts, establishes goals with supervisors, tracks progress, and prepares data for presentation.
• Interprets and maintains compliance with performance standards, federal and state regulations including EMTALA and HIPAA, policies, procedures, guidelines, and third-party contracts.
• Reports to assigned supervisor.
• This position may have additional or varied physical demand and/or respiratory fit test requirements. Please consult the Physical Demands Project SharePoint site or contact Risk Management/Employee Health for additional information.
• Normal office conditions. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.
• 4 years of Patient Access operations activities (scheduling/registration/insurance) or related experience (billing, collections, accounts receivables)
• Previous experience in one of the following: scheduling, registration, insurance, billing, collections, and customer service in either a hospital or physician's office setting
• Bachelor's degree in related field or Healthcare Certification (AAHAM CRCS, HFMA CRCR, NAHAM CHAA) preferred
• Previous experience with Microsoft Office programs and experience with admission/discharge/transfer or billing/claims management software
• Previous experience with medical terminology, basic ICD 10 and CPT coding healthcare program reimbursement and methodologies
• Previous experience in 3+ of the following: scheduling, registration, insurance (including Medicare, Medicaid, and third-party regulations), billing, collections, and customer service in either a hospital or physician's office setting
• Must be able to communicate effectively with others in English (verbal/written).