Minimum Qualifications:
-
High school diploma or equivalent.
-
NJ Family Care Presumptive Eligibility certification must be completed within six months of employment if working in the Emergency Department, Labor & Delivery or Outpatient Registration.
-
Ability to communicate effectively both verbally and in writing sufficient to perform the essential functions; read, understand and apply policies and guidelines; and obtain information from a variety of sources.
-
0-1 years of experience in healthcare registration or relevant customer service environment.
-
Knowledge of general computer and data entry functions.
-
Excellent communication, organizational and analytical skills.
-
Excellent customer service skills with internal and external customers.
-
Ability to keep up in a very fast-paced environment.
POSITION SUMMARY
The Patient Access Associate I is responsible for the patient registration process, general admissions and uninsured/underinsured procedures. This position verifies third-party payer accounts, pre-authorization and/or pre-certification requirements. The Patient Access Associate I communicates and collaborates with Patient Access team members and other ancillary departments as needed. The Patient Access Associate I is responsible for scheduling telehealth visits at Hammonton SED via the InTouch Solo scheduling platform.
The Patient Access Associate I will be knowledgeable of state and federal government funding programs, such as Medicare, Medicaid and TRICARE/CHAMPUS; workers' compensation; no fault auto; and commercial insurance payers. The Patient Access Associate I will be knowledgeable of billing and reimbursement guidelines and methodologies for state and federal government and non-government payers, insurance terminology, basic medical terminology, EMTALA, HIPAA privacy and compliance practices.
The Patient Access Associate I is responsible for verifying diagnosis codes; completing medical necessity checks for Medicare; and completing and identifying patient liabilities, including estimates for self-pay, copays and deductibles. The Patient Access Associate I must have basic knowledge of ICD-10 in order to ensure accurate diagnosis entry for reimbursement.
The Patient Access Associate I will perform duties after an eight-week training program under the supervision of the Patient Access Leadership Team and Revenue Cycle Quality & Assurance Training Team. This position is a customer service champion responsible for delivering great customer service at each entry point throughout the health system. This position is also responsible for patient throughput, established wait times and turnaround (TAT) times for all Patient Access areas, along with aiding in the achievement of top box customer service scores for each respective Patient Access site.
The Patient Access Associate I must pass annual recertification with score of 90% or better. The Patient Access Associate I can perform job duties based on department procedure and protocol; may require direct oversight. Attends all required trainings and in-services and passes all competency tests associated with the in-services. The Patient Access Associate I needs to become certified in the NJ Family Care Presumptive Eligibility process within the first six months of employment.
This position maintains a high accuracy rate of 98% or higher and established productivity rates for key performance indicators (KPI), such as cash collections wait and TAT times, and pre-registration and registration productivity.
The Patient Access Associate I must achieve Valued Contributor or above on their annual evaluation with no written disciplinary documents on file. The Patient Access Associate has the opportunity for advancement to Patient Access Associate II if all of the above requirements are satisfied and the incumbent has been in the role for one year. In order to advance via the Patient Access career path, the Patient Access Associate I must complete the coursework and Litmos Revenue Cycle Certified Professional I or HFMA Certified Revenue Cycle Representative certification. The Patient Access Associate I must pass the annual recertification with a minimum score of 95%. This requirement is expected to be maintained every year after the upgrade. Staff member will be required to retake training and exam until they obtain the appropriate grade or disciplinary action will be taken in regards to performance.
The Patient Access Associate I must achieve an evaluation rating of Valued Contributor the year of consideration and every year after. If the Valued Contributor rating is not achieved in the following years, an action plan will be put in place to remediate the staff member back to Valued Contributor and no further considerations for the career path program will be allowed until the staff member formally achieves Valued Contributor on their next annual evaluation.
This position supports organizational goals by providing high-level, quality customer service; participating in performance improvement efforts'; and demonstrating a commitment to teamwork and cooperation while verifying and preparing all patient accounts for inpatient and outpatient billing in order to maximize payment for hospital and clinic services from all sources. The Patient Access Associate I may be responsible for additional duties as assigned with respect to the Patient Access job scope.
QUALIFICATIONS
-
EDUCATION: High school diploma or equivalent required. Ability to communicate effectively both verbally and in writing sufficient to perform the essential functions; read, understand and apply policies and guidelines; and obtain information from a variety of sources required. Bilingual a plus.
-
LICENSE/CERTIFICATION: NJ Family Care Presumptive Eligibility certification must be completed within six months of employment if working in the Emergency Department, Labor & Delivery or Outpatient Registration.
-
EXPERIENCE: 0-1 years of experience in healthcare registration or relevant customer service environment required. Knowledge of general computer and data entry functions required. Experience in a physicians' office or hospital setting is preferred. Excellent communication, organizational and analytical skills required. Ability to keep up in a very fast-paced environment required. Candidates must continuously display professionalism, courtesy and respect to all customers that always mirror AtlantiCare's Values/Behaviors. Candidate must have reliable means of transportation.
PERFORMANCE EXPECTATIONS
Demonstrates the competencies as established on the Assessment and Evaluation Tool for this position.
WORK ENVIRONMENT
Potential for exposure to the hazards and risk of the hospital environment, including exposure to infectious disease, hazardous substances and potential injury.
This position requires reaching, stooping, kneeling and crouching approximately 25% of the workday. This position requires frequently lifting, approximately 25-30 pounds, and occasional lifting of 50-100 pounds with assistance. This position also requires pushing and pulling computers on wheels approximately up to 100% of the day if assigned to the Emergency Department or Labor & Delivery. High-volume, fast-paced environment.
The essential functions for this position are listed on the Assessment and Evaluation Tool.
REPORTING RELATIONSHIP
This position reports to department leadership.
The above statement reflects the general details considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.
AtlantiCare is an equal opportunity employer that takes affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability.