JOB SUMMARY
The Patient Access Coordinator 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
  Communication:
• Effectively communicates information to staff, internal and external customers
• Creates strong customer service orientation and collaboration
• Provides excellent customer service to all internal and external customers
  Liaison:
• Contacts insurance companies, patients, and providers regarding authorizations, medical necessity, and financial responsibility
• Serves as liaison between payers and hospital departments/physician offices or patients in resolving front end errors which would result in denials
  Reporting:
• Assists in preparation of monthly error reports and other error reports as requested
• Assists in preparation of monthly collections reports and other collection reports as requested

   
   QUALIFICATIONS  Education

   Education LevelEducation DetailsRequired/Preferred

   High School Diploma or GED Equivalent

   
  Licenses and Certifications

   
   Licenses and CertificationsLicenses and Certifications DetailsTime FrameRequired/
  Preferred

   

  Work Experience

  Number of YearsWork Experience DetailsRequired/
  Preferred

  1-3 yearsExperience/knowledge of managed care reimbursement methodology including ICD-10, CPT-4 and/or HCPCS and DRGsPreferred

  1-3 yearsPatient Access, Claims, Billing/Follow Up, or Revenue Cycle experiencePreferred

  Knowledge Skills and Abilities

  Knowledge, Skills, AbilitiesRequired/PreferredProficiency
  Working knowledge of Registration systems, Medicare/Medicaid/Third Party Liability/Workers Compensation requirementsRequiredN/A
  Proficient in Microsoft Office (Word, Excel, and Outlook)RequiredN/A
  Knowledge of applicable state and federal regulations relating to registering accounts and collecting at point of serviceRequiredN/A
  Excellent negotiating and analytical skillsRequiredN/A
  Strong verbal and written communication skills;RequiredN/A
  Excellent interpersonal skills;RequiredN/A
  Effectively and efficiently prioritizes and organizes tasksRequiredN/A
  Provides supervision to direct reportsRequiredN/A
  Develops, implements/evaluates projects (timely & efficient manner)RequiredN/A
  Evaluates and provides coaching for all employees within the scope of responsibilityRequiredN/A
  Ensures accurate and timely collection of all appropriate patient estimatesRequiredN/A
  Ensures effective monetary management of DepositsRequiredN/A
  Ensures timely and accurate processing of accounts in accordance with best practices, defined workflow, procedures, and applicable legislature/ regulationsRequiredN/A
  Gathers and relays information with knowledge, tact, and diplomacyRequiredN/A
  Experiences daily contact with co-workers, patients, payers, and other NMHS/NMMC staff membersRequiredN/A
  Exhibits strong written and verbal communication skillsRequiredN/A
  Reflects a positive, caring attitude toward clients, patients, staff, and the public we serveRequiredN/A
  Evaluates and coaches reporting employees to accomplish major goals and objectivesRequiredN/A
  Develops, implements/evaluates projects in a timely & efficient mannerRequiredN/A

  SCOPE
  Freedom To Act:
  Problem Solving:
  Impact:
  Financial Responsibility:

• Sales Revenue Target Responsibility:
• Approval Responsibility:
• P & L Responsibility:
• Assets Controlled:
• Controllable Expenses (e.g., Payroll and other budgeted items):
• Total Financial Responsibility:
  Budget Responsibility
• Primary Budget Responsibility:
• Shared Budget Responsibility: