patient service specialist

Vanderbilt University Medical Center

<div>Discover Vanderbilt University Medical Center : Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt&rsquo;s mission is to advance health and wellness through preeminent programs in patient care, education, and research.
Organization:
VIP MS, RHC - Springfield
Job Summary:
The Patient Service Specialist is responsible for working directly with patients and their families to discuss any questions, complaints, comments, or suggestions. Facilitates efficient workflow, supports appropriate use of technology, and engages in effective communication.
.
KEY RESPONSIBILITIES
<ul><li>Proficiently performs all Patient Service Specialist job responsibilities.
</li><li>Schedules appointments
</li><li>Manages registration and patient work queues.
</li><li>Coordinates with patients to ensure all pre-appointment tasks are completed prior to patient visit.
</li><li>Communicates with patients using critical decision making to route appropriately as applicable.
</li><li>The responsibilities listed are a general overview of the position and additional duties may be assigned.
</li></ul>TECHNICAL CAPABILITIES
<ul><li>CUSTOMER SERVICE (Intermediate): A continuing focus on the needs and requirements of customers, anticipating their needs, remaining sensitive to customers while performing services for them, responsive to customer needs.
</li><li>PATIENT SCHEDULING (Novice): The ability to coordinate and schedule patient appointments with computer systems in the clinic.
</li><li>PATIENT DOCUMENTATION (Novice): The ability to receive and record patient information.
</li><li>MEDICAL TERMINOLOGY &amp; DOCUMENTATION (Novice): The ability to comprehend medical terminology and
</li><li>APPOINTMENT &amp; PRODECURAL SCHEDULING (Fundamental Awareness): The ability to coordinate and schedule appointments.
</li></ul>Core Accountabilities:
<ul><li>Organizational Impact: Performs tasks that are typically routine that may impact team's performance with occasional guidance.
</li></ul><ul><li>Problem Solving/Complexity of work: Utilizes some discretion and research to solve routine problems.
</li></ul><ul><li>Breadth of Knowledge: Applies knowledge of standards, established processes and procedures that apply to the job.
</li></ul><ul><li>Team Interaction: Provides guidance to entry level co-workers.
</li></ul>Core Capabilities :
Supporting Colleagues : Develops Self and Others: Continuously improves own skills by identifying development opportunities.- Builds and Maintains Relationships: Seeks to understand colleagues' priorities, working styles and develops relationships across areas.- Communicates Effectively: Openly shares information with others and communicates in a clear and courteous manner. Delivering Excellent Services: - Serves Others with Compassion: Invests time to understand the problems, needs of others and how to provide excellent service.- Solves Complex Problems: Seeks to understand issues, solves routine problems, and raises proper concerns in a timely manner. - Offers Meaningful Advice and Support: Listens carefully to understand the issues and provides accurate information and support. Ensuring High Quality: - Performs Excellent Work: Checks work quality before delivery and asks relevant questions to meet quality standards. - Fulfills Safety and Regulatory Requirements: Demonstrates basic knowledge of conditions that affect safety and reports unsafe conditions to the appropriate person or department. Managing Resources Effectively : - Demonstrates Accountability: Takes responsibility for completing assigned activities and thinks beyond standard approaches to provide high-quality work/service. - Stewards Organizational Resources: Displays understanding of how personal actions will impact departmental resources. - Makes Data Driven Decisions: Uses accurate information and good decision making to consistently achieve results on time and without error. Fostering Innovation : - Generates New Ideas: Willingly proposes/accepts ideas or initiatives that will impact day-to-day operations by offering suggestions to enhance them. - Applies Technology: Absorbs new technology quickly; understands when to utilize the appropriate tools and procedures to ensure proper course of action. - Adapts to Change: Embraces changes by keeping an open mind to changing plans and incorporates change instructions into own area of work.
Key Qualifications:
Language Skills: Bilingual in Spanish and English required.
Work Experience:
Relevant Work Experience
Experience Level :
2 years
Education
High School Diploma or GED (Required)
Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more.
At our growing health system, we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth, appreciation of benefits, and a sense of community and purpose.
Core Accountabilities:
* Organizational Impact: Performs tasks that are typically routine that may impact team's performance with occasional guidance. * Problem Solving/ Complexity of work: Utilizes some discretion and research to solve routine problems. * Breadth of Knowledge: Applies knowledge of standards, established processes and procedure that apply to your own job. * Team Interaction: Provides guidance to entry level co-workers.
Core Capabilities :
Supporting Colleagues : Develops Self and Others: Continuously improves own skills by identifying development opportunities.- Builds and Maintains Relationships: Seeks to understand colleagues' priorities, working styles and develops relationships across areas.- Communicates Effectively: Openly shares information with others and communicates in a clear and courteous manner. Delivering Excellent Services: - Serves Others with Compassion: Invests time to understand the problems, needs of others and how to provide excellent service.- Solves Complex Problems: Seeks to understand issues, solves routine problems, and raises proper concerns in a timely manner. - Offers Meaningful Advice and Support: Listens carefully to understand the issues and provides accurate information and support. Ensuring High Quality: - Performs Excellent Work: Checks work quality before delivery and asks relevant questions to meet quality standards. - Fulfills Safety and Regulatory Requirements: Demonstrates basic knowledge of conditions that affect safety and reports unsafe conditions to the appropriate person or department. Managing Resources Effectively : - Demonstrates Accountability: Takes responsibility for completing assigned activities and thinks beyond standard approaches to provide high-quality work/service. - Stewards Organizational Resources: Displays understanding of how personal actions will impact departmental resources. - Makes Data Driven Decisions: Uses accurate information and good decision making to consistently achieve results on time and without error. Fostering Innovation : - Generates New Ideas: Willingly proposes/accepts ideas or initiatives that will impact day-to-day operations by offering suggestions to enhance them. - Applies Technology: Absorbs new technology quickly; understands when to utilize the appropriate tools and procedures to ensure proper course of action. - Adapts to Change: Embraces changes by keeping an open mind to changing plans and incorporates change instructions into own area of work.
Position Qualifications:
Responsibilities:
Certifications:
Work Experience:
Relevant Work Experience 
 
Experience Level:
2 years
Education:
High School Diploma or GED
Vanderbilt Health is committed to fostering an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity. EOE/Vets/Disabled.</div>

Bilingual Patient Service Specialist | Full Time | Outpatient | Pediatrics

Oregon Health & Science University

<div>Department Overview:

The PAS Specialist at Family Medicine at South Waterfront provides excellent clinical care through professional response to patient needs. This role is responsible for all reception duties, including check in, check out, telephones, and providing a high level of administrative support to both providers and patients. This will include gathering appropriate and correct patient demographics, financial screening, worker compensation status, and non-covered service status. Will schedule appointments including but not limited to new patient, ancillaries, procedure services, and follow-up appointments. Gathers and records information about patients, provides specific customer services which include screening for financial eligibility, confirming health insurance coverage, and individual's obligations. Maintains current information on all managed care insurance plans and is up to date with all insurance plan changes. Solid administrative skills, including letter/phone correspondence, organizational skills, project maintenance, and other general office tasks.
Function/Duties of Position:
<ul><li>Outpatient Clinic: Greet and check-in new patients to the practice providing a high level of customer service in preparation for the visit. This position will also check in / out established patients, make return appointments, answer incoming calls, provide high quality customer service to both external customers (patients, referring providers, and insurance carriers) and internal customers (OHSU health care providers and staff) that meet or exceeds the service standards of the health care industry. Obtain prior medical records and studies when appropriate. Enter all information accurately into OHSU databases or into the medical record when necessary. Answer all basic appointment questions. Determine and collect co-payments/cash handling. Applies problem solving and negotiating skills in resolving patient concerns. Provides high level of support to providers and patients.</li><li>
Answer incoming phone calls, verify account information including, but not limited to, demographics, insurance, and Primary Care Provider. Will schedule appointments including but not limited to new patient, ancillaries, procedure services, and follow-up appointments. Maintains current information on all managed care insurance plans and is up-to date with all insurance plan changes, utilizing information to efficiently and effectively obtain authorizations as appropriate. Solid understanding of ICD10/CPT coding requirements and issues. Responsible for keeping the schedule flowing smoothly and on time. Applies problem solving and negotiating skills in resolving patient concerns. Creates telephone and routes telephone encounters with accurate information for medical staff from patients or patient&rsquo;s representative. Manages providers schedule and completes administrative work for team providers.</li><li>
Enrollment &amp; Eligibility. Gathers and/or verifies patient information including demographics, insurance coverage, and financial status. Confirms patient eligibility for health care coverage and clarifies any managed care arrangements. Obtains authorizations for clinical care, procedures, and laboratory studies.
</li><li>Performs other administrative duties and/or projects as requested by providers, managers, and supervisors.
</li><li>Offers MyChart access.
</li></ul>Required Qualifications:
<ul><li>Six months of work experience in a medical office setting, including high volume direct patient contact OR one year of work experience in a high volume direct public contact position</li></ul>
Knowledge and Skills Required:<ul><li>
Basic computer keyboarding skills including typing of 30 - 45 wpm.</li><li>
Note: Successful completion of a formal OHSU Administrative Internship Program will substitute for one year of experience. Contact Compensation for confirmation of eligibility.</li></ul>
Preferred Qualifications:
<ul><li>Two or more years of experience in a medical office setting.</li><li>
Previous OHSU and EpicCare experience.
</li></ul>Additional Details:
<ul><li>Exposure to ill patients - flu, colds, virus. Must be able to sit for long periods, move about the clinic as necessary, and use telephone and computer for extended periods of time.</li></ul>
Why apply to OHSU?: We are Oregon's only public academic health center. In addition to caring for patients, we lead groundbreaking research. We also train the next generation of health care professionals. As Portland's largest employer, we give you opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington. All are welcome. OHSU welcomes people of all ages, ethnicities, genders, national origins, religions and sexual orientations. We are striving to build an anti-racist, multicultural institution and encourage people with diverse backgrounds to apply. To request reasonable accommodation, contact askhr@ohsu.edu</div>

PAS Specialist (Patient Access Service Specialist)

North East Medical Services

<div>SUMMARY OF POSITION: 
The Patient Account Specialist I interprets EOBs for correct payment verification, adjustments, and denials. The Patient Account Specialist I is also responsible for handling outstanding claims on aging reports and resolving patient inquiries regarding billing statements and insurance overage-related matters. The Patient Account Specialist I has to maintain up-to-date knowledge about CPT, ICD-10 CM, billing regulations, and payers' requirements. The Patient Account Specialist I has to comply with HIPAA guidelines and maintain confidentiality regarding patient account status and the organization's financial affairs.
<h1 class="jobSectionHeader">ESSENTIAL JOB FUNCTIONS:</h1><ul><li>
Reviews, edits, processes, and submits electronic and hardcopy claims to various payers (Medicare, Medicaid, Managed Care, and Private Insurance) for FQHC (Federally Qualified Health Centers) and FFS (Fee-For-Service) reimbursement, ensuring accuracy of payment entries and completeness of charge capture information.</li><li>
Maintains up-to-date knowledge of medical billing requirements for FQHC Medi-Cal, Medicare, state, local programs, and private insurance payers.</li><li>
Reports issues or payment trends (e.g., charges applied to the wrong visit, incorrect billing codes) to the supervisor for resolution.</li><li>
Edits charge/claim details and corrects submission errors to ensure accuracy.</li><li>
Researches and resolves outstanding claims on aging reports to minimize delays in reimbursement.</li><li>
Responds to payer requests and remittance advices promptly and professionally, including phone calls, letter responses, appeals, and submission of medical records or additional information as required.</li><li>
Under the guidance of the Patient Account Specialist II, addresses patient inquiries and billing complaints by making necessary adjustments, exploring all options to secure claim payments, referring complex issues to appropriate staff, and ensuring proper follow-up.</li><li>
Posts charges and submits claims for NEMS physicians&rsquo; hospital visits.</li><li>
Provides training and support to the Billing Department and front desk staff in Member Services, Medical, Dental, Optometry, Laboratory, and Radiology Departments.</li><li>
Adheres to policies and procedures for billing records retention.</li><li>
Acts as a liaison between physicians, insurance companies, and third-party organizations by processing and verifying invoices, ensuring claim reimbursements, and auditing patient accounts.</li><li>
Performs additional duties as assigned by management.</li></ul><h1 class="jobSectionHeader">
</h1><ul><li>Completion of an AA/AS degree is required, and a 4-year university diploma is preferred or maybe substituted with a minimum of 3 years of work experience in healthcare.
</li><li>Working experience in a healthcare or FQHC setting is preferred</li><li>
Working experience with Epic PB Resolute is preferred</li><li>
Familiar with Medicare, Medicaid, Private insurances, Managed Care (HMO &amp; PPO), CPT, and ICD-10 CM</li><li>
Must have excellent analytical and communication skills</li><li>
Must be proficient in computer skills</li><li>
Ability to write business correspondence</li><li>
Strong organizational skills to coordinate multiple, varied billing processes simultaneously</li><li>
Upholds high customer service standards in a demanding and complex health care organization</li><li>
Demonstrates initiative, resourcefulness, integrity and dedication to timeliness to achieve high customer satisfaction levels</li>
Self-motivated, diligent, organized, resourceful, responsible, and enthusiastic 
<li>
</li></ul>LANGUAGE:<ul><li>
Proficient in written and spoken English and Chinese (Cantonese and/or Mandarin)</li>
Fluent in other languages is an asset 
<li>
</li></ul>STATUS:<ul><li>
This is an FLSA Non-exempt position.
</li><li>This is not an OSHA high-risk position.</li>
This is a Full Time position. 
<li>
</li></ul>NEMS is proud to be an Equal Opportunity Employer welcoming diversity in our workforce. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
NEMS BENEFITS: Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children; and company contribution to 401(k).</div>

PATIENT ACCOUNT SPECIALIST I

Naven Health, Inc

<div>Extraordinary Careers. Endless Possibilities.
With the nation&rsquo;s largest home infusion provider, there is no limit to the growth of your career.
 Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and team members.
Join a company that is taking action to develop an inclusive, respectful, engaging and rewarding culture for all team members. At Option Care Health your voice is heard, your work is valued, and you&rsquo;re empowered to grow. Cultivating a team with a variety of talents, backgrounds and perspectives makes us stronger, innovative, and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare.
Job Description Summary:
The Patient Access Specialist supports patients referred to Option Care Health to receive Specialty Infusion Services by coordinating referrals, intake documentation, and cross-functional communication to ensure a seamless transition into care.
 
 
This role partners closely with referral sources, sales, pharmacy, nursing, and internal teams to support timely access to therapy while delivering a consistent, high-quality experience for patients and referral partners.
Job Description:
Job Responsibilities<ul><li>
Engages with patient, referral source, sales, pharmacy, and nursing to coordinate discharge and secure nursing and delivery.</li><li>
Creates, communicates and obtains all required documentation for new referrals.</li><li>
Secures patient&rsquo;s upfront payment including assisting patients to find avenues for payment where needed (identifies opportunities and directs patient to financial assistance program).</li><li>
Supports the ongoing activities needed to ensure clean claims on hold and denial management (follow-up on paperwork where missing).</li><li>
Assist Supervisor and Manager with special assignments as needed.</li></ul>
Supervisory Responsibilities
Does this position have supervisory responsibilities? NO
(i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.)
Basic Education and/or Experience Requirements
High school diploma or equivalent is required.
Minimum of two years of experience in related experience required.
Basic Qualifications
Ability to multi-task and support numerous referrals/priorities at one time.
Ability to work in a fast past environment.
Must be detail-oriented and have a high degree of quality focus.
High degree of customer service skills required.
Ability to trouble shoot, problem solves and collaborate with cross-functional team members across sales and operation functions.
Travel Requirements
N/A
Preferred Qualification &amp; Interests
Previous healthcare/medical billing experience preferred.
May perform other duties as assigned
Due to state pay transparency laws, the full range for the position is below:
Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.
Pay Range is $22.55-$32.63
Benefits:<ul><li>Medical, Dental, &amp; Vision Insurance</li><li>Paid Time off</li><li>Bonding Time Off</li><li>401K Retirement Savings Plan with Company Match</li><li>HSA Company Match</li><li>Flexible Spending Accounts</li><li>Tuition Reimbursement</li><li>myFlexPay</li><li>Family Support</li><li>Mental Health Services</li><li>Company Paid Life Insurance</li><li>Award/Recognition Programs</li></ul>
Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information.</div>

Patient Access Specialist - California REMOTE

Neighborhood Healthcare

<div>About Us

Community health is about more than just vaccines and checkups. It&rsquo;s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We&rsquo;re with you every step of the way, with the care you need for each of life&rsquo;s chapters. At Neighborhood, we are Better Together. 
 
As a private, non-profit 501(C) (3) community health organization, we serve over 500,000 medical, dental, and behavioral health visits from more than 96k people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance. 
 
We have been doing this since 1969 and it is our employees that make this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If that sounds like an organization you want to be a part of, we would love to have you.

The Patient Services Representative (PSR) works to support the mission and vision of Neighborhood Healthcare by supporting clinics with front office tasks. The PSR&rsquo;s primary roles are to directs incoming calls to ensure they are transferred to the appropriate contact within the clinic and assist patients with scheduling and re-scheduling healthcare appointments.

RESPONSIBILITIES

Direct Patient Care
<ul>
<li>Assesses incoming phone calls to determine the correct course of action based on customer's information and needs</li>
<li>Corresponds with patients, salespeople, and visitors in an accurate, expeditious, courteous, and competent manner via in-person, telephone, and/or mail</li>
<li>Conducts appointment reminder calls to all patients; including noted documents required for their visit</li>
<li>Impacts patient experience by demonstrating courteous and helpful behavior and a commitment to accuracy</li>
</ul>
Provider and Team Support
<ul>
<li>Generates daily lists of scheduled appointments for the clinic</li>
<li>Shares accountability for overall patient health outcomes by working in coordination with care teams</li>
<li>Operates to instill confidence in our care and facilities to patients, fellow employees, and other stakeholders</li>
</ul>
Clinical Administration
<ul>
<li>Schedules appointments and enter all required data into electronic scheduler</li>
<li>Tracks and records filled and cancelled appointments</li>
<li>Prepares patient charts prior to their appointments</li>
<li>Verifies patient appointments and arrival time at registration</li>
<li>Receives and records patient payments in computer and ledger for services received</li>
<li>Verifies patient records are up to date and accurate; makes appropriate changes in computer system, as needed</li>
<li>Completes ongoing/annual training for position compliance</li>
</ul>
EDUCATION/EXPERIENCE
<ul>
<li>High school diploma/GED required</li>
<li>One year customer service experience required; in a healthcare setting preferred</li>
<li>Experience working with electronic medical records and multi-phone lines preferred</li>
<li>Bilingual (English/Spanish) highly preferred</li>
</ul>
ADDITIONAL QUALIFICATIONS (Knowledge, Skills and Abilities)
<ul>
<li>Excellent verbal and written communication skills, including superior composition, typing and proofreading skills</li>
<li>Ability to interpret a variety of instructions in written, oral, diagram, or schedule form</li>
<li>Knowledgeable about and experience with customer service etiquette and protocols</li>
<li>Ability to interact effectively with clinic personnel, patients, and diverse populations</li>
<li>Ability to successfully manage multiple tasks simultaneously</li>
<li>Excellent planning and organizational ability</li>
<li>Ability to use computer programs, such as spreadsheets and databases</li>
<li>Ability to work as part of a team as well as independently</li>
<li>Ability to work with highly confidential information in a professional and ethical manner</li>
</ul>
Physical Requirements
<ul>
<li>Ability to lift/carry 20 lbs/weight</li>
<li>Ability to stand for long periods of time</li>
</ul>
Pay range: $22.88 - $32.03 per hour, depending on experience.

Compensation Disclosure: The posted salary range reflects the designated pay grade for this position. While this range represents the broader classification of the role, actual compensation will be based on several factors, including but not limited to: the candidate&rsquo;s overall knowledge, skills, and experience, market data and industry benchmarks, internal equity within the organization, Budgetary considerations and organizational needs. As a result, placement within the range is not guaranteed, and the full pay grade range may not be utilized.</div>

Patient Services Representative-Prenatal/Women's Health (Temporary)

Presbyterian Healthcare Services

<div>Location Address:
9521 San Mateo NE Albuquerque, NM 87113-2237

Compensation Pay Range:
Minimum Offer $15.60 Maximum Offer $22.12 Now Hiring: Patient Access Account Specialist I-ABQ
Summary:
Under the direction of the Patient Access Supervisor, the Patient Access Account Specialist I provides basic functions to financial clear patient accounts for government and commercial accounts prior to the date of service. Performs basic financial clearance functions, including insurance verification, authorization, collection and documentation of patient demographics, benefit analysis, and pre-service collections. The Patient Access Account Specialist I will ensure follow up on authorizations for scheduled and Urgent/Emergent procedures and admissions until date of service or discharge for admissions. The Patient Access Account Specialist I must possess a basic knowledge of Medicare (CMS) guidelines, as well as other Compliance Regulatory guidelines applicable to Patient Access to include HIPAA, EMTALA, and CMS guidelines of MSPQ. The Patient Access Account Specialist (PAAS I) monitors work queues for financial clearance and missing authorizations ensuring a payment source is identified and secured and there is a clean claim for billing. The Patient Access Account Specialist I acts as resource to all employees within Patient Access. The Patient Access Account Specialist I is responsible for providing the highest level of customer service to patients, ancillary departments and payers when financially clearing accounts. The PAAS I will work with ancillary departments to ensure the procedures scheduled and authorized meet payer requirements. The Patient Access Account Specialist I provides coverage to other areas and hospitals as needed to minimize overtime and guarantee the patients receive services as needed without registration delays. Type of Opportunity: Full time Job Exempt: No Job is based: Reverend Hugh Cooper Administrative Center Work Shift: Days (United States of America)

Responsibilities:
Customer Service and Caring Practices: *Achieve exceptional patient experience for patients and patient families by using CARES, AIDET and EPE tools. *Addresses and attempts to appropriately resolve complaints in the moment by using key words at key times and de-escalation processes. *Ability to manage conflict and appropriately request the help of a supervisor when needed. *Implement PROMISE and CARES behaviors in every encounter. *Educates patients for whom they speak regarding insurance benefits and liabilities. *Ensures accounts are financially cleared prior to date of service to alleviate patient concerns over hospital financial matters Encounter Components: *Performs the patient registration process. Manage the accurate collection of patient data which includes but is not limited to; *Obtain/confirm and enter demographic and other financial and clinical information necessary for final clearance of scheduled accounts. *Review Urgent/Emergent admission accounts for notification, financial clearance and authorization pre-discharge. *Obtain missing insurance information, to include policy number, group number, date of birth, and insurance phone number if not already identified in account. *Verify insurance for eligibility and benefits using online electronic verification system or by contacting payer directly. *Review and process work queues related to Patient Access pre-visit or urgent/emergent admissions, per department guidelines. *Review of accounts falling within the work queues to ensure the insurance information contains accurate policy ID#s, Group Name and Numbers, Subscriber information, Authorization numbers, as well as correct payer and Coordination of benefits prior to date of service. *Accurately document actions taken in the system of record to drive effective follow-up and ensure an accurate audit trail. *Maintain ongoing knowledge of authorization requirements and payer guidelines. Maintain a proficient knowledge of Medicare (CMS) guidelines as it relates to admissions and outpatient services. Ensuring compliance with admissions forms, benefit entitlement verification, and billing requirements *Ensure accurate completion of MSPQ prior to date of service. *Daily focus on attaining productivity standards; recommend new approaches for enhancing performance and productivity when appropriate. *Monitor and track Data Quality program to ensure errors are corrected prior to final bill and correct accounts as necessary. *Maintain appropriate records, files, and timely and accurate documentation in the system of record. *Work with ancillary departments to ensure coding, diagnosis and facility are authorization are in alignment. *Work with payers to ensure authorization is in place; initiating the auth when appropriate. *Coordinate efforts with Financial Advocates to secure payer source current and future visits. *Monitor work queues to identify late add-on accounts and complete financial clearance procedures prior to services to avoid unauthorized procedures from being performed. *Work with physician offices to resolve discrepancies in authorizations and scheduled procedures. Financial Accountabilities: *Collects identified patient financial obligation amounts including residual balance if applicable. Collect liability from patient prior to visit or make arrangements for payment at time of service. *Ensure a payer source has been identified prior to services being rendered. *Ensure authorization for correct procedure (CPT), facility, and date of service is obtained. Patient Relations *Contact patients pre-visit to complete any information missing from the account to ensure accuracy prior to visit. *Transparency with patients through communication of patient liabilities and authorization issue in a timely manner, allowing patients ability to make informed decisions. *Educate patients and answer questions from patients on benefits, liabilities and financial options. *Provide patient with way-finding for appointment at time of pre-registration. *Perform AIDET when speaking to patient to alleviate anxiety and confusion. Quality Improvement: *Perform assigned patient care responsibilities, which may include but not limited to: *Cooperate fully in all risk management activities and investigations. *Report promptly any suspected or potential violations to laws, regulations, procedures, policies, and practices, and cooperate in related investigation. *Conduct all transactions in compliance with all company policies, procedures, standards, and practices. *Demonstrate knowledge of all applicable compliance and legal requirements of the job based on the scope of practice of the position. C.A.R.E.S Behaviors: *Demonstrates CARES behaviors of Collaborate, be Accountable, Respect, Engage and Serve to all whom you encounter. *Other duties as assigned
Qualifications:
*High school diploma, continued education preferred *External and Internal Non-Patient Access Candidates: Pass Patient Academy with passing score of 85% or higher *Previous completion and passing of Patient Access Advocate II and III Advancement test. *A minimum of 2 years of work experiences in healthcare setting within Patient Access and/or billing plus strong customer service background. *Strong knowledge and understanding of insurance and financial processing of accounts. *Proficient in EPIC ADT system *Specialty Certifications: CHAA, CHAM or other industry equivalent certification preferred *Pass annual competency exam for all areas of responsibility. *Requires general knowledge of the customer encounter process which may include registration, contract requirements, and coordination of benefits. *Knowledge in Microsoft Office Products. *Demonstrated strong keyboarding skills, ensuring efficient data entry and documentation. *Pass EPIC proficiency test required with a 85% score at completion of the Epic Training class. UPDATED 7/29/25
All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits. 
Wellness 
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more. 
Why work at Presbyterian? 
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. 
About Presbyterian Healthcare Services 
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.<h1 class="jobSectionHeader">
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services</h1></div>

Patient Access Account Specialist I-ABQ

East Alabama Medical Center

<div><ul><li><div>EAMC MISSION
</div><ul><li><div><div>At East Alabama Medical Center, our mission is high quality, compassionate health care, and that statement guides everything we do. We set high standards for customer service, quality, and keeping costs under control.</div>
</div></li></ul></li><li><div>POSITION SUMMARY</div>
<ul><li><div><div>The Patient Processing Pre-certification Scheduling Specialist functions in a high volume, fast-paced environment. The Specialist provides courteous and efficient service to patients and physician offices while scheduling requested appointments across multiple locations. Concise communication skills and excellent customer service are a must for this position. The Specialist should be a driven, self-motivated individual who is able to move between tasks quickly, making the most of their time.</div>
</div></li></ul></li><li><div>POSITION QUALIFICATIONS</div>
<ul><li><div><div>Minimum Education
</div><ul><li><div>High School Diploma or equivalent</div>
</li></ul></div></li><li><div><div> 
Minimum Experience
</div><ul><li><div>1-2 years customer service experience, including working on a computer.</div>
</li></ul></div></li><li><div><div> 
Required Registration/License/Certification
</div><ul><li><div>N/A</div>
</li></ul></div></li><li><div><div> 
Preferred Education
</div><ul><li><div>Associate Degree in Business or Health related field, Knowledge of Medical Terminology Preferred, Knowledge of ICD-10 and CPT coding preferred</div>
</li></ul></div></li><li><div><div> 
Preferred Experience
</div><ul><li><div>1-2 years healthcare/hospital experience and/or customer service experience.</div>
</li><li><div>1-year computer experience and the ability to type and spell accurately.</div>
</li></ul></div></li><li><div><div> 
Preferred Registration/License/Certification</div>
<ul><li><div>Certification of Patient Accounts preferred.</div>
</li></ul></div></li><li><div><div> 
Other Requirements</div>
<ul><li><div>N/A</div>
</li></ul></div></li></ul></li></ul> 
Location: EAMC &middot; RAD SUPP 
Schedule: FT, First Shift</div>

PATIENT PROCESSING PRE CERT SCHEDULING SPECIALIST - OIFED

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