Patient Access Specialist
Company: OMNI FAMILY HEALTH
Location: Bakersfield
Posted on: May 23, 2023
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Job Description:
Title: Patient Access Specialist
Job Summary: Facilitates timely access to care by ensuring patient
eligibility and benefits are verified prior to services. Works with
health plans to transfer patients to Omni Family Health (OFH) and
obtain prior authorization for services when required. Performs
check out function and reconciles scheduled appointments with
posted charges on a daily basis. Responsible for correcting claims
and posting errors. Has knowledge of commonly used medical terms
and procedures.
Job Duties:
1. Verify eligibility and benefits for scheduled patients and
same-day appointments according to OFH policy.
2. Work with Omni staff and health plans to assist patients with
switching patients to an OFH provider (PCP).
3. Resolve registration and authorization issues prior to patient
visit. Obtain authorizations for pre-determined procedures when
required. Ensure all information required to complete the billing
process is obtained prior to patient checkout.
4. Update patient account to indicate pertinent information
required for billing. Review RTS manager daily to correct errors
identified prior to patient visit.
5. Assist patients with identifying the appropriate "Financial
Assistance Program" within OFH that meets their needs. Coordinates
these needs with Health Center leadership, scheduling &
Navigators.
6. Research documentation with physician and/or other medical
personnel if clarification is required. Maintains an effective
working relationship with OFH providers and Health Center
leadership.
7. Post charges for completed encounters during checkout.
8. All other related duties as directed by the Billing
Supervisor.
Job Requirements:
1. Ability to work under pressure.
2. Ability to handle multiple functions.
3. Understanding of community based organizations.
4. Ability to demonstrate effective communication skills (verbal,
nonverbal, written) with the medical/dental staff and Office
managers.
5. Ability to work proficiently and efficiently in a timely
manner.
6. Ability to problem-solve and make decisions consistent with
organizational policies and procedures
7. Able to work independently, demonstrating effective initiative,
follow-through, organizational skills
8. Knowledge of all payer codes.
9. Knowledge of all programs offered by OFH.
10. Promotes and believes in OFH mission statement.
11. Ability to relate to the public regardless of ethnic, religion
and economic status.
Additional Duties:
1. HIPAA compliance - Responsible for maintaining abreast of and in
compliance with all HIPAA regulations and requirements. Treats all
member information confidential.
2. Compliance - Ensure compliance with all local, state and federal
regulations.
3. QA/QI - Participate in QA/QI activities and contribute towards
the overall performance improvement of the organization.
4. IT - Required to learn and use the Electronic Health Record and
Practice Electronic System) and its components. As required by the
job functions and highlighted in the Policies and Procedures. These
components include NextGen, PMS, QSI and other electronic features,
as they are developed and implemented, as applicable to work
environment.
5. All employees will participate in Patient Centered Health Home
Model at Omni Family Health.
Qualifications, Education, and Experience:
1. High school graduate or GED with a minimum of two year's
experience in handling billing and account receivables in a similar
healthcare environment.
2. Working knowledge of coding rules, regulations, and third party
payer requirements preferred.
3. Must possess good customer service skills and professionalism to
interact with internal and external customers, patients and
staff.
Responsible To: Billing Supervisor
Classification: Full or Part Time, Non-exempt
Keywords: OMNI FAMILY HEALTH, Bakersfield , Patient Access Specialist, Other , Bakersfield, California
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