Patient Access Spec I WMCG - Nights

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Work Shift

Day (United States of America)

Schedule: Monday, Thursday and Friday Night 7:30PM- 7:30AM

Job Summary:

• This job is typically the first point of contact and must ensure a pleasant experience for patients and visitors.
• Interviews patients and/or their representatives to obtain complete and accurate demographic, financial and
• insurance information, required for billing and collecting patient accounts. Conducts intensive screening of all
• Medicare, Medicaid and managed care patients for pre-certification requirements and provider service eligibility,
• prior to registration. Obtains all necessary customer consents/attestations.
• Coordinates the collection of all estimated patient liabilities, including co-payments and unmet deductibles.
• Verifies insurance benefits and coverage for inpatients and outpatients. Responds to customer requests and
• answers questions regarding various service and account information. Analyzes and rectifies customer concerns
• using established procedures. Uses computer to access and/or update customer records.
• Verifies and posts transactions. Follows established procedures for processing receipts, cash etc. Sorts and files
• various documents. Assists with general hospital information and directions to departments within and outside
• of the WHS facility. Establishes financial arrangements to reduce financial risk for WHS, helping to ensure that
• WellStar is reimbursed for its services.

Core Responsibilities and Essential Functions:

• Quality/ Safety
• Receives requests for reservations (patient scheduling) from physicians offices and makes
• the necessary pre-admission arrangements, referring to lists of dates allotted for scheduling,
• and advising physicians office staff of unavailable dates.
• Interviews each patient or representatives to obtain complete and accurate demographic,
• financial and insurance information.
• Enters all patient information into the registration system.
• Obtains all necessary signatures and is knowledgeable regarding any special forms that may
• be required by the patients third party payer.
• Reads physicians orders to determine the procedures requested and to instruct patients
• accordingly.
• Escorts or arranges to have patient escorted to procedure areas and assigned rooms.
• Makes corrections and updates patient account information in computer.
• Obtains new medical record numbers for newborn admissions and other new patients.
• Documents thorough explanatory notes on patient accounts, concerning any non-routine
• circumstances, clarifying special billing processes.
• Maintains a working knowledge of available information system capabilities and performs all
• system applications that are required.
• Understands and applies WHS philosophy and objectives, and PAS policies and procedures, as
• related to assigned duties. Understands the admission, outpatient and emergency registration
• process.
• Maintains confidentiality of patient information, in accordance with WHS policy and HIPPA
• regulations.
• Consistently demonstrates the ability to organize work, recognizes and establishes
• appropriate work priorities, and completes work in a productive manner, without creating
• backlogs.
• Maintains proficiency in data entry skills.
• Assists physicians and their office staff to expedite scheduling, pre-admission, Medicaid
• screening and pre-certifications on all accounts.
• Resolves error and applicable Claim, DNB, and Patient Work Queues.
• Customer Service
• Greets all guest with a positive and professional attitude.
• Receives patients valuables for safekeeping in the hospital safe.
• Answers incoming phone calls and follows through with requests made.
• Maintains courteous and cooperative working relationships with WHS management, patients,
• physicians, other professional contacts, and the general public. Demonstrates ability to
• tactfully handle difficult situations.
• Presents a well-groomed and professional image in coordination with dept/ hospital dress
• codes.
• Expected Performance, Behaviors and Results:
• The WellStar Experience (Must demonstrate a commitment to Service Excellence by):
• Creating first impressions, memorable moments and impressions that fulfill the expressed
• and unexpressed wishes and needs of patients and family members.
• Valuing patients and family members as partners in their care.
• Having world-class processes in place.
• Delivering high-touch care that is reliable, responsive and coordinated.
• Focusing on constant innovation and creating improvements.
• Celebrating our diversity with sensitivity and understanding.
• Embracing the idea that we are all owners of our health system.
• Budget/Financial
• Attempts to collect the estimated self-pay balance of all inpatient, outpatient and ER
• accounts, at the earliest possible collection control point.
• Monitors in-house accounts and attempts to make financial arrangements with guarantors for
• payment of their self-pay balances in full, prior to discharge, or within ten working days
• thereafter.
• Completes financial evaluation forms to document guarantors' income, expenses, assets and
• liabilities.
• Identifies those patients without adequate insurance coverage. Makes personal contact with
• patient or guarantor to determine guarantor's ability to pay non-covered charges, as well as
• to determine potential eligibility for financial assistance programs (namely Medicaid).
• Maintains a list of health care financial assistance programs and the eligibility requirements
• for each program. Refers patients/guarantors to sources of outside funding assistance, as
• needed.
• Works efficiently and accurately within designated time frames to ensure a continuity of
• information and cash flow.
• Contacts scheduled patients at home to obtain pre-admission information, explain financial
• policies, estimate self-pay balances, and obtain a promise to pay on or before
• admission/registration.
• Interviews all inpatients and select (self-pay) outpatients at time of registration, or at least
• within 24 hours of admission, to verify complete insurance and financial information, explain
• financial policies, and collect the estimated self-pay balance.
• Documents concise and understandable notes regarding all self-pay account collection
• activity, as well as each patient or guarantor interaction. Documents all efforts to collect
• patient account balances, other self-pay collection activities and referrals to Medicaid.
• Coordinates financial counseling activities with Admitting, Outpatient Registration, Emergency
• Registration, Utilization Review, Nursing, Social Services, and Patient Financial Services.
• Verifies insurance coverage and benefits.
• Exceeds monthly quota on a consistent basis. Formally reports results of self-pay collection
• activity to direct supervisor, on a daily basis or according to policy. Provides feedback to PAS
• management concerning self-pay collection and data integrity issues.
• Responsible for completion of appropriate error/issues in Work Queues.
• Identifies and resolves Payor Denials as indicated.
• General
• Observes work hours and provides proper notice of absences, tardies work schedule changes.
• Attends select departmental meetings at the request of WHS Management.
• Completes monthly, quarterly, and annual mandatory training as required.
• Performs other duties as assigned.
• Performs other duties as assigned
• Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

High School Diploma / GED General or Associates General-Preferred

Required Minimum License(s) and Certification(s):

All certifications are requir