Patient Access Specialist - Behavioral Health Operations

Job Description - Patient Access Specialist 3 - Behavioral Health Operations (260003VS)

Job Description

Patient Access Specialist 3 - Behavioral Health Operations - ( 260003VS )

Description

• Responsible for verifying demographic, confidential clinical and financial information necessary to accurately and efficiently execute insurance verifications, notifications, authorizations, pre-certifications, et al, to support claim processing and reimbursement for scheduled and unscheduled hospital services.
• Responsible for calculating, communicating and collecting all patient financial responsibilities based on the patient’s health plan(s) prior to the scheduled date of service.
• Works directly with nurses, medical staff, ancillary departments, insurance carriers, care management/utilization, HIM, scheduling and other external professionals to assist patients with obtaining health care and financial services.
• Recognizes and adheres to all CMS, JCAHO, and HIPAA requirements when validating the hospital account.
• Refer potential Medicaid or County patients to FAS for Medicaid application and approval; monitor all in-house accounts for possible financial issues.
• Provides clinic office visit self-pay pricing to unfunded patients.

• High School Diploma or GED

• Two (2) years of experience in Patient Access as a PAS 2 or equivalent with scheduling and/or registration and/or insurance verification in a healthcare setting.
• An equivalent combination of education and years of experience may be considered.

• Proficient with word processing, databases, spreadsheets and EMR platforms and applications.
• Knowledge of CMS, TJC, AHCA regulations as pertaining to hospital registration, UB billing compliance.
• Knowledge of Medicaid, Medicare, Commercial Insurance, Healthcare Marketplace Insurance and Hillsborough County Health Care Program (HCHCP).
• Knowledge of commercial, federal, state and third-party payors.
• Exceptional time management and organization skills.
• Ability to handle difficult and stressful situations with professional composure.
• Ability to provide excellent customer service.
• Ability to analyze, organize and prioritize work while meeting multiple deadlines.
• Ability to identify and/or calculate patient responsibility (copays, deductible, out-of-pocket maximums, coinsurance).

Tampa

TGH Main Campus 1 Tampa General Circle Tampa 33601

Eligible for Remote Work :
Hybrid Remote

Full-time

Scheduled Days :
Monday, Tuesday, Wednesday, Thursday, Friday