Patient Access Associate

Company: UnityPoint Health
Location: Moline
Posted on: June 6, 2021

Job Description:

Overview

The Patient Access Associate is responsible for obtaining accurate and thorough demographic and financial information for each patient visit. Ensures that appropriate signatures, financial information and precertification requirements are secured. Screens for benefit eligibility on appropriate accounts. Informs/educates patients that have not been pre-registered of their financial responsibility reviewing deductibles, coinsurance, allowable and copayments. An estimate is developed and reviewed with each patient. Collection process is initiated and posted to the patient's account.

When these functions are completed with accuracy this process will ensure patient safety through appropriate identification, maximum reimbursement for hospital charges and compliance with all state and federal regulations.

Interacts in a customer focused and compassionate manner to ensure patients and their representative's needs are met, and that they understand the medical center's policies for the resolution of patient financial liabilities and the various available payment options.

UnityPoint Health - Trinity, in the Quad Cities, is a regional integrated health care delivery system including four full-service hospitals in Rock Island and Moline, Illinois and Bettendorf and Muscatine, Iowa with a total of 584 licensed inpatient beds. Trinity's hospitals, clinics, home health care agency, mental health center, health sciences college and residency program employ more than 3,000 employees. Together, we are working toward physician-driven, patient-centered care to achieve our vision of delivering the best outcome for every patient, every time.

The Quad Cities is a connected, creative and prosperous bi-state community on the banks of the mighty Mississippi River. The region is made up of Davenport and Bettendorf in Iowa - Moline, East Moline, and Rock island in Illinois - and other surrounding communities. The Quad Cities is a great place to live and work. It offers something for everyone including arts and culture, amazing festivals and events, innovative and superior schools and universities, and quality healthcare. The Quad Cities is a premier destination for young professionals and families and sits only hours away from Chicago, St. Louis, and Des Moines.

Responsibilities

Essential Functions/Responsibilities:

• Accurately and thoroughly collects, analyzes and records demographic, insurance/financial and clinical data in computer system. Ensures information source is appropriate.
• Updates and edits information in computer, ensuring that all fields are populated correctly and appropriately.
• Completes eligibility check and obtain benefits though electronic means or via phone contact with insurance carriers or other agencies.
• Contacts patients/families/physicians to obtain additional demographic/insurance information and update in computer system if needed in order to proceed with verification process.
• Interpret physicians' hand-carried orders to determine service needs and scans physician orders or verifies that complete and valid orders are on file for each patient.
• Obtains information and completes MSPQ and other payer-specific documents.
• Reviews and explains all registration forms prior to obtaining signatures from patient or appropriate patient representative.
• Explain benefits and request copay as well as deductible and coinsurance as applicable.
• Identifies prearranged payment commitment and follows instructions as outlined by the financial clearance department.
• Completes registration checklist.
• Ensure that all monies collected are secure or turned over to appropriate associates/cash posting specialists.
• Documents in system (comment field in demographic screen or hospital account note) any activity comments.
• Identifies patients in financial hardship and refer to Patient Financial Coordinators/Certified Application Counselors for charity/financial assistance
• Refers to Cash Posting Specialists requiring payment plans.
• Ensures each patient's identification band is correct by asking the patient to review the information and initial the band and then assure it is securely fastened upon completion of this identification process.
• Notify patients of need for ABN (for Medicare) or noncovered waiver requirements.
• Documents on accounts using hospital account note with activity comments to ensure easy account followup.
• Identifies payer requirements for preauthorization. If preauthorization not in place, contact Financial Clearance Department.
• Performs followup visits to patients in nursing areas, ER treatment room or clinical departments to obtain additional registration information, documents and/or signatures. Followup may be performed via phone if appropriate to the situation (making sure a witness is on hand if necessary).
• Arranges or assists with patient transport as necessary.
• Answers phones and routes calls as necessary.
• Maintains physician not in system master file as instructed and assigned.
• Monitors and maintains multiple work queues as instructed and assigned.
• Monitor tracking system and print orders and transcribe and scan into computer system.
• Contacts patients/families for preregistration to obtain additional demographic/insurance information and update in computer system if needed in order to proceed with verification process.
• Requests patient to bring required documents on day of service, i.e., physician orders, insurance cards, claim forms, liability information, photo ID, etc.
• Documents in system the need for front-end patient access associates to collect at time of service any copay or deductible that could not be collected during the preregistration process.

Qualifications

Education: Requires minimally a high school diploma or GED. Some college is preferred.

License(s)/Certification(s): Hands only CPR

Experience: Prior customer service experience required. Two years of experience in a hospital patient access/patient accounts department, medical office/clinic or insurance company preferred. Experience interacting with patients and a working knowledge of third party payers and collection preferred. Prior experience with verification and payer benefit and eligibility systems preferred. Knowledge of medical terminology preferred.

Knowledge/Skills/Abilities: Technical aptitude - ability to learn new systems quickly. Data entry. Communication - both written and verbal. Customer/Patient focused. Interpersonal skills. Managing priorities. Multicultural sensitivity. Planning/organizing skills. Problem solving

Professionalism. Teamwork. Flexibility of schedule.

Other: Use of usual and customary equipment used to perform essential functions of the position.

Keywords: UnityPoint Health, Moline , Patient Access Associate, Other , Moline, Illinois