Patient Access Specialist 3 - Behavioral Health Operations

Under general supervision of the Patient Access Manager or Supervisor and in accordance with established policies, procedures and professional guidelines, gathers and records all necessary information in the process of financially clearing a hospital procedure, service or stay. Demonstrates expertise with all proficiencies of a PAS 2. Responsible for performing job duties in accordance with mission, vision and values of Tampa General Hospital.

Essential Functions

• 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.

Education

• High School Diploma or GED

Work Experience

• 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.

Technical Knowledge, Skills, and Abilities

• 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).