Cherokee Indian Hospital Authority is an Equal Opportunity Employer (Minorities/Females/Disabled/Veterans).  To read more about this, view the EEO is the Law poster and this EEO is the Law Poster Supplement

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PTI Patient Access Specialist
Job Code:2021-02-030
Department:Patient Access
FT/PT Status:Part Time Intermittent
Salary Minimum17.12
Salary Midpoint19.26
  
Position Closes:

Job Responsibilities & Qualifications:

Primary Function

Responsible for greeting incoming patients, conducting patient interviews, distributing and obtaining signatures for paperwork, enter pertinent information including demographic and insurance, verifying insurance eligibility, explaining services and eligibility to patients and answer the switchboard.

 

Job Description

  • Interviews patients to obtain pertinent patient registration information; i.e. demographic and insurance information and authorization to enable the Business Office to bill for health care services provided from all alternate resources, including the non-beneficiary service.
  • Assists patients in completing new or updating charts in the BPRM Patient Registration System- This will include inpatient, outpatient, emergencies and after hour patients, dental patients, and mental health patients.
  • Obtains and verifies the health records in the BPRM Patient Registration System for Medicaid, Medicare, and private/commercial insurance eligibility information for all patients seen prior to all clinic visits.
  • Obtains signature for file on all required forms for alternate resource and contract health services prior to patients being seen in the clinics for billing purposes and/or contract health services eligibility.
  • Makes corrections as necessary to improve the Patient Registration System. Updates PRC eligibility with proper documentation.
  • Collects third party recipient health cards, obtains photocopies of the card and explains the program to the beneficiaries; i.e. why Medicare, Medicaid and/or Private Insurances will be billed for services they receive at the Cherokee Indian Hospital.
  • Interviews patients to obtain information to initiate a new health record and/or communicate to Medical Records to reactivate a retire/stored record.
  • Enters all information into the BPRM Patient Registration System and prints appropriate forms.
  • Upon direction initiates all admitting forms to complete the admission with current patient data, including BPRM Patient Registration System. Initiates patient identification bands for admission.
  • Completes Medicare Secondary Payer Questionnaire for Medicare beneficiaries and files appropriately.
  • Transcribes all new insurance information into the BPRM system in all the appropriate fields.
  • Verifies if patient has NC BCBS, NC Medicaid or other private insurance.
  • Calls pending verification patients before appointments to remind of documentation to bring in i.e., driver’s license, enrollment care, proofs of residency, etc.
  • Obtains patient signature for Service Agreements, Notice of Privacy Practices, etc., scans forms signed by patients into VISTA.
  • Documents MVA/WC in BPRM/RPMS by obtaining signatures for appropriate forms, giving clinic appropriate documents, obtaining police reports, entering appropriate benefit for coverage in order for the Business Office to bill correctly and alerts clinic staff.
  • Documents all changes and updates on the notes page with date and initials.
  • Collects fees and co-pays from non-beneficiaries, prints register and credit card report at end of shift, maintains petty cash and turns all receipts and reports into Finance.
  • Answers eligibility questions for new patients and lets patients know what they are eligible for when getting a new chart.
  • Answers telephone switchboard for all CIHA facilities and directs calls to appropriate staff member/department.
  • Maintains an updated list of all departments, personnel and extensions to assure proper transfer of calls.
  • Greets visitors when necessary, answers questions, or directs them to the appropriate person.
  • Maintains the vendor sign in and provides vendor with Visitor badge.
  • Keeps a log of after hour call-in referrals and turns into PRC during regular business hours
  • Performs other duties as requested from the Patient Registration Manager.

 

Job Knowledge

  • Basic knowledge of eligibility requirements of the Cherokee Indian Hospital.
  • Works closely with Supervisor and Medical Records Manager when screening for non-eligible patients.
  • Basic Medical Terminology.
  • Requires the ability to operate a computer, calculator, typewriter, and related office equipment.
  • Requires knowledge of various software packages: i.e. Microsoft Excel, Word, Outlook, etc.
  • Knowledge of interview techniques and experience in applying various policies and procedures in the performance of assigned duties.
  • Must be able to read, research, and interpret computer data related to patient interviews and eligibility searches.
  • Must be able to maintain specified records, files, and logs of the department.
  • Must have excellent communication skills, both written and verbal.
  • Requires the ability to work independently or as a member of a team.
  • Valid NCDL required.

 

Education/Experience

  • An Associates Degree in Business and/or Accounting, or a related field, or the equivalent combination of training, education, and experience is required.
  • Previous data entry experience or clerical experience with customer contact of two years is required.
Three to six months in the job would be necessary to become proficient in most phases of the work.