Patient Access Advocate -Emergency Department-CDS

Location Address:

2400 Unser Blvd, Rio Rancho, New Mexico 87124, United States of America

Compensation Pay Range:

Minimum Offer $: 15.58

Maximum Offer for this position is up to $: 21.19

Position Title: Patient Access Advocate I - Emergency Department (CDS)

Summary:

The Patient Access Advocate I provides primary registration of patient accounts for self‑pay, government and commercial accounts on date of service for scheduled and unscheduled visits. Performs registration functions, including updating of demographics, insurance verification, collection of point‑of‑service liabilities and documentation of registration information within the ADT system. Confirms that the account registered has accurate information to ensure clean billing. Must possess basic knowledge of Medicare (CMS) guidelines, as well as other compliance regulatory guidelines applicable to Patient Access.

Provides the highest level of customer service to patients/family at time of service through registration interactions as well as providing way finding to patients and/or visitors.

Type of Opportunity: Full time

Job Exempt: No

Job is based: Presbyterian Rust Medical Center

Work Shift: 12 Hour Nights (United States of America)

• Provide exemplary patient experience using CARES, AIDET and EPE tools.
• Address and resolve complaints in the moment using key words at key times and de‑escalation processes.
• Manage conflict and request supervisor help when needed.
• Implement PROMISE and CARES behaviors in every encounter.
• Educate patients regarding insurance benefits and liabilities.
• Ensure accounts are financially cleared at time of service through account review to alleviate patient concerns over hospital financial matters.
• Perform patient registration process and accurately collect patient data, including but not limited to demographic and financial information not obtained during pre‑registration/financial clearance.
• Obtain missing insurance information (policy number, group number, date of birth, insurance phone number) if not already identified.
• Verify insurance eligibility and benefits via online electronic verification or by contacting payer directly.
• Accurately document actions in the system of record for effective follow‑up and audit trail.
• Maintain knowledge of authorization requirements, payer guidelines, and Medicare (CMS) guidelines as they relate to admissions and outpatient services; ensure compliance with admissions forms, benefit entitlement verification, and billing requirements.
• Ensure accurate completion of MSPQ at time of service if not completed during financial clearance.
• Maintain focus on attaining productivity standards.
• Monitor and track data quality program to correct errors at time of service.
• Maintain appropriate records, files and timely documentation in the system of record.
• Collect identified patient financial obligation amounts, including residual balance, at time of service.
• Educate patients on financial assistance, charity or other programs available.
• Refer to on‑site Financial Advocate or Financial Advocacy Center as appropriate.
• Complete missing account information to ensure accuracy at visit.
• Communicate patient liabilities transparently.
• Cooperate fully in risk‑management activities and investigations.
• Report promptly any suspected or potential violations of laws, regulations, procedures, policies, and practices, and cooperate in investigation.
• Conduct all transactions in compliance with company policies, procedures, standards, and practices.
• Demonstrate knowledge of all applicable compliance and legal requirements.
• Demonstrate CARES behaviors:
  Collaborate, be Accountable, Respect, Engage, and Serve to all whom you encounter.

• High school diploma/GED.
• 6 months experience in a healthcare setting or 1 year customer service background.
• Pass 2‑week Patient Access Academy with a passing score of 85% or higher (within 6 months of start).
• CHAA, CHAM, or other industry‑equivalent certification preferred.
• Basic understanding of insurance preferred.
• Basic understanding of medical terminology and billing codes (DRG, ICD‑10, CPT, HCPCS) preferred.
• Basic understanding of registration and healthcare.
• Strong keyboarding…