Altru Health System

Patient Access Specialist

Location
Grand Forks, ND
Salary
Join our team!
Posted
Nov 09, 2020
Ref
26484
Industry
Healthcare
Job Type
Long-Term
Candidates may work in the following locations:

Thief River Falls, MN 56701
Crookston, MN 56716

The Patient Access Specialist gathers necessary insurance and demographic information from patients. They use their expertise to translate the information provided by the patient/guarantor into the computer system with the result of an accurate claim submission. May be responsible for some or all of the following: insurance verification, prior authorization, pre-certification, referrals, second opinion management, insurance assignments and/or workers compensation authorizations.

ESSENTIAL JOB FUNCTIONS
Patient Access Specialist
  • Supports and models behaviors consistent with the mission, vision and values of Altru Health System.
  • Answers phone and provides excellent customer service.
  • Ensures and adheres to strict confidentiality when handling patient charts, records, and scheduling information.
  • Accurately registers patients into the EPIC system by collecting and recording demographic, insurance, financial, and clinical data in the computer system.
  • Records and collects necessary patient account documents.
  • Collects self-pay balances, pre-payment amounts, and co-pays per guidelines.
  • Interprets physician orders and referrals to determine service needs and schedule patient visits while coordinating appointments with other departments to meet the needs of the patient and provider.
  • Creates accounts for new patients and update accounts for previous patients to ensure accurate services and account processing.
  • Utilizes appropriate strategies to activate and/or verify the insurance coverage of patients and obtain benefit information such as co-payment, and co-insurance amounts
  • Maintains knowledge of and complies with third-party payers' requirements for verifying insurance information, obtaining authorizations/pre-certifications, and completing other activities to ensure services are billed and reimbursed appropriately.
  • Reviews Medicare accounts for completed MSPQ.
  • Modifies work schedule to meet department goals/deadlines and the needs of the department and patients.
  • Completes bed placements for patient admitted to the hospital. (Hospital positions only.)
  • Performs other duties as assigned or needed to meet the needs of the department/organization.

Required:

  • High school diploma or GED.
  • One year of applicable experience, preferably in healthcare or customer service environment.
  • Demonstrates proficient computer skills with a high degree of accuracy for a variety of computer-related tasks.
  • Must complete Orientation and Training courses upon hire, HBI Orientation Level I course within 60 days of hire, and HBI Orientation Level II courses by 1 st common review period.
  • Completes HBI medical terminology course within 6 months of hire.

Preferred:

  • Knowledge in medical terminology.
  • Past experience in a clerical health care setting.
  • Associate's or Bachelor's Degree from accredited institution