This position has access to and knowledge of extremely sensitive, private and confidential materials. Ability to maintain the highest standard is required with zero tolerance.
All the primary duties within this document will be performed according to established policies, procedures and guidelines within the department and the Medical Center.
The Patient Access Technician-CHA 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 .
PRIMARY JOB DUTIES:
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.
11. Demonstrates standards of performance (ownership, teamwork, communication, compassion) that support patient satisfaction and principles of service excellence.
12. Documents all communication concerning patient's financial responsibility in the Hospital Account Note in EPIC.
13.Tracks cancellations and no-shows. Informs physicians when a patient cancels or fails to come in for their appointment.
14. Performs other related duties as required
ESSENTIAL JOB SPECIFICATIONS:
1.Education: High school diploma or equivalent required
2.Licensure/Certifications: Certified Patient Access Technician (CPAT) or Certified Health Access Associate (CHAA) certification preferred.
3.Experience: One-year business office experience in health care setting with computer knowledge and data entry. Medical Office experience preferred with experience in Charge Entry/Billing.
New Hanover Health Network