JOB SUMMARY

The Patient Access Specialist at North Mississippi Health Services is responsible for supporting the overall financial health of the organization by completing the daily activities of the collecting and input of Insurance Information, Point of Service Collections and Financial Arrangements, & Customer Service via Direct Contact with Patients and their family members. This role operates under the guidance of the Patient Access Manager and requires an experienced individual with excellent analytical, organizational, and communications skills to manage Demographic and Insurance Information. resolve real time edits & denials, and interface effectively wit h internal and externa l stakeholders to promote timely and accurate patient flow and collections.

JOB FUNCTIONS

Scheduling:

Responsible for scheduling/rescheduling, pre-certifying, checking medical necessity, and pre-registering patients for appointments, diagnostic tests, and outpatient procedures as ordered by referring providers
Obtains necessary information required for scheduling, pre-certification, and pre-registration
Obtains and/or verifies patient demographics, insurance information/eligibility, and benefits
Responsible for informing patients and/or clinical staff of the proper preparation and instructions for the tests ordered
Notifies patient of the location of the appointment date & time, test, and/or procedure

Patient Experience:

Obtains crucial confidential patient identification information including patient records, signatures, and payment information repeatedly and ensures HIPAA guidelines are enforced
Effectively communicates NMHS' organizational revenue cycle and financial policies including estimates, charity plans and payment options to patients and patient representatives
Provides bedside registration to obtain consent form signatures, collect insurance, and other confidential information pertinent information to ensure accurate medical record data entry that aligns with CMS and other regulatory agencies

Collections & Financial Arrangements:

Ensures team members are providing estimates to guarantors for elective procedures and collection attempted at the point of pre-registration or point of service
Ensures team members are administering ABNs when necessary
Ensures accounts are financially secure prior to service
Ensures timely and accurate processing of accounts in accordance with best practices, defined workflow, procedures, and applicable legislation/regulations

Denials Management:

Corrects front end errors real time to minimize denial throughput
Develops strategy for consistently obtaining accurate, timely, and beneficial patient demographic information
Review post service denials to assist in developing front end strategies to reduce denial inflow
Identifies trends and reports potential significant and recurring issues along with possible solutions to leadership
Takes proactive, corrective action through systematic and procedural development to reduce incoming denials

Contract Management:

Maintains familiarity with payer methodologies to ensure accurate estimates are communicated with patients & system variances are communicated with leadership
Manages expected reimbursement to ensure appropriate patient portion is collected prior to service
Develops strategy for partnering with business office to ensure estimates & transparency are accurate
Analyzes estimate variances to understand where/why deviations occurred
Identifies trends and reports potential significant and recurring issues along with possible solutions to leadership

QUALIFICATIONS

Education

Bachelor's Degree In Business, Healthcare, Coding, or equivalent field. Required
Associate's Degree Willing to consider 4 years Patient Access, Claims, Billing/ Follow-Up, or revenue cycle experience beyond minimum requirement in lieu of Bachelor degree. Required
High School Diploma or GED Equivalent Willing to consider 8 years Patient Access, Claims, Billing/ Follow-Up, or revenue cycle experience beyond minimum requirement in lieu of Bachelor degree. Required Licenses and Certifications Work Experience
1-3 years
1-3 years Knowledge Skills and Abilities
Working knowledge of Registration systems, Medicare/Medicaid/Third Party Liability/Workers Compensation
Proficient in Microsoft Office (Word, Excel, and Outlook)
Knowledge of applicable state and federal regulations relating to registering accounts and collecting at point of service
Excellent negotiating and analytical skills
Strong verbal and written communication skills
Excellent interpersonal skills
Effectively and efficiently prioritizes and organizes tasks
Develops, implements/evaluates projects (timely & efficient manner)
Ensures accurate and timely collection of all appropriate patient estimates
Ensures effective monetary management of Deposits
Ensures timely and accurate processing of accounts in accordance with best practices, defined workflow, procedures, and applicable legislature/ regulations
Gathers and relays information with knowledge, tact, and diplomacy
Experiences daily contact with co-workers, patients, payers, and other

NMHS/NMMC

staff members

Exhibits strong written and verbal communication skills
Reflects a positive, caring attitude toward clients, patients, staff, and the public we serve
Evaluates and coaches reporting employees to accomplish major goals and objectives
Develops, implements/evaluates projects in a timely & efficient manner
Effectively communicates information to staff, internal and external customers Physical Demands A thorough completion of this section is needed for compliance with legal standards such as the Americans with Disabilities Act. The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
Standing . Occasionally
Walking . Occasionally
Sitting . Frequently
Lifting/Carrying . Occasionally 20 lbs
Pushing/Pulling . Rarely
Climbing . Rarely
Balancing . Rarely
Stooping/Kneeling/Bending . Rarely
Reaching/Over Head Work . Occasionally
Grasping . Frequently
Speaking . Frequently
Hearing . Constantly
Repetitive Motions . Frequently
Eye/Hand/Foot Coordinations . Occasionally Benefits A vailable
Continuing Education
403B Retirement Plan with Employer Match Contributions
Pet, Identity Theft and Legal Services Insurance
Wellness Programs and Incentives
Referral Bonuses
Employee Assistance Program
Medical Benefits
Dental Benefits
Vision Benefits
License + Certification Reimbursement
Life, Long-Term and Short-Term Disability, Group Accident, Critical Illness and Hospital Indemnity Insurance
Employee Discount Program

Other:

Early Access to Earned Wages
Tuition Assistance
Relocation Assistance
Paid Time Away
Special Employee Rates at NMMC Wellness Centers Physical Demands A thorough completion of this section is needed for compliance with legal standards such as the Americans with Disabilities Act. The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
Standing . Occasionally
Walking . Occasionally
Sitting . Frequently
Lifting/Carrying . Occasionally 20 lbs
Pushing/Pulling . Rarely
Climbing . Rarely
Balancing . Rarely
Stooping/Kneeling/Bending . Rarely
Reaching/Over Head Work . Occasionally
Grasping . Frequently
Speaking . Frequently
Hearing . Constantly
Repetitive Motions . Frequently
Eye/Hand/Foot Coordinations . Occasionally Benefits A vailable
Continuing Education
403B Retirement Plan with Employer Match Contributions
Pet, Identity Theft and Legal Services Insurance
Wellness Programs and Incentives
Referral Bonuses
Employee Assistance Program
Medical Benefits
Dental Benefits
Vision Benefits
License + Certification Reimbursement
Life, Long-Term and Short-Term Disability, Group Accident, Critical Illness and Hospital Indemnity Insurance
Employee Discount Program

Other:

Early Access to Earned Wages
Tuition Assistance
Relocation Assistance
Paid Time Away
Special Employee Rates at NMMC Wellness Centers _We believe a career is more than just a career - it's a calling.

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Patient Access Specialist- Business Office