Patient Access Specialist II>

Job Family Summary: As part of Revenue Cycle Management, this position is responsible for creating a positive first impression of M Health Fairview and ensuring an exceptional experience is achieved while interacting closely with patients, families, and other internal and external stakeholders in a highly organized and professional manner. This position must utilize effective interpersonal skills to gather patient demographic for a complete and accurate registration, identifies insurance, gathers benefits, communicates, and collects patient's financial obligations. Individuals in this role are expected to demonstrate the M Health Fairview commitments (Integrity, Service, Compassion, Innovation and Dignity) along with critical thinking skills, a strong work ethic and flexibility.

Days of Work:

Wk 1=Monday, Tuesday,Saturday and Sunday

Wk 2= Monday, Tuesday, Wednesday

Hours: 11p-730a

Job Expectations:  

• Interview patients to obtain and document accurate patient demographic and insurance information in the medical record.  
• Use insurance knowledge and resources to accurately code insurance and verify eligibility using online, web-based or phone systems to ensure accuracy and expedite payment. 
• Perform check-in process including collection of co-pays, signatures on forms, scanning insurance cards and/or IDs and provide patient with any notices according to regulatory requirements. Support price transparency through patient education and collection on estimated financial responsibilities and refer patient to financial assistance/counseling resources as appropriate 
• Interact with patients and families in challenging and unique situations that may require de-escalation skills.   
• Manage daily worklists and/or work queues and resolve assigned tasks in a timely, accurate, and efficient manner.  Assist in training and mentoring new and existing staff. 
• Confirm insurance benefits for services including coverage limitations, referral or authorization requirements and patient liabilities. 
• Provide proactive price estimates and communicate to patient to help them understand their financial responsibilities and collect. Inform patient of gaps in coverage, educate patient on available options and refer to financial counseling for assistance. 
• Prepare and communicate/deliver notices of non-coverage to patients (ex: HINN, ABN, waiver, Medicare lifetime reserve days). 
• Follow up with payers on active authorized referral requests to verify determination or payer step in determination process. 
• Collaborate and exhibit strong relationships with other departments and team to manage tasks, according to established criteria in a high-volume environment. Provide resources and contacts to patients as needed to ensure a seamless experience for the patient. 
• Adhere to all compliance, regulatory requirements, department protocols and procedures. Protect patient privacy and only access information as needed to perform job duties. 
• Contributes to the process or enablement of collecting expected payment 
• Participates in improvement efforts and initiatives that support the organizations goals and vision. Understands and Adheres to Revenue Cycle’s Escalation Policy.  

Organization Expectations, as applicable:  

• Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served.  

• Partners with patient care giver in care/decision making. 
• Communicates in a respective manner. 
• Ensures a safe, secure environment. 
• Individualizes plan of care to meet patient needs. 
• Modifies clinical interventions based on population served. 
• Provides patient education based on as assessment of learning needs of patient/care giver. 

• Fulfills all organizational requirements. 

• Completes all required learning relevant to the role. 
• Complies with and maintains knowledge of all relevant laws, regulations, policies, procedures and standards. 

• Fosters a culture of improvement, efficiency, and innovative thinking. 
• Performs other duties as assigned.  

Minimum Qualifications to Fulfill Job Responsibilities (Qualifications):

Experience 

• 1 years combination of customer service, and/or position in healthcare. 
• Working knowledge and ability to perform accurately and efficiently on EMR, Microsoft Office Suite, and other computer programs. 
• Effective communication skills (both written and verbal), attention to detail, self-directed and a positive attitude are essential. 
• Ability to work independently and in a team environment. 

License/Certification/Registration 

Preferred 

Education 

• Post-Secondary Education 

Experience 

• Previous Epic experience 
• Prior collections experience in a medical setting 

License/Certification/Registration  

N/A  

Level to which this Job reports:  ​SUPV​ 

Does this job have direct reports:  ​No​ 

Does this job have indirect reports:  ​No​