Admitting Clerk jobs in Albuquerque, NM

Overview

The Patient Access Advocate II provides registration of patient accounts for government and commercial accounts on date of service for scheduled and unscheduled visits. Perform registration functions, including updating of demographics, insurance verification, authorizations, collection of point of service liabilities and documentation of benefit analysis and registration information within the ADT system. Confirm and follow up on authorization for scheduled visits and make certain account being registered has accurate information to ensure clean billing. Provide coverage to other areas as needed to minimize overtime and guarantee the patients receive services as needed without registration delays. Must possess a strong knowledge of Medicare (CMS) guidelines, as well as other Compliance Regulatory guidelines applicable to Patient Access. Monitor accounts to identify any duplications and correct prior to patient receiving services to ensure patient safety. Provide the highest level of customer service to patients/family at time of service through registration interactions as well as providing wayfinding to patients and/or visitors.

Type of Opportunity: Full Time FTE: 1.000000 Exempt: No Work Schedule: 12 Hour Days

Qualifications

*High school diploma/GED*Internal Candidates: 2 years experience in Patient Access and/or billing, plus strong customer service background. (External: 3 years healthcare experience)*Pass Patient Access Advocate II Advancement test (External: within 6 months of start).*External: Pass 2 week Patient Access Academy with a passing score of 85% or higher. *CHAA, CHAM or other industry equivalent certification preferred*Strong understanding of insurance and financial processing of accounts.*Basic understanding of medical terminology and billing codes (DRG, ICD-10, CPT, HCPCS)*Proficient in EPIC ADT system*Requires general knowledge of the customer encounter process which may include registration and healthcare practices, financial guidelines, and coordination of benefits.*Knowledge in Microsoft Office Products

Education:Essential:* High School Diploma or GED

Responsibilities

Customer Service and Caring Practices:*Ability to provide 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 at time of service through account review. to alleviate patient concerns over hospital financial mattersEncounter 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 information, not obtained during pre-registration/financial clearance process, necessary for account completion. *Review Urgent/Emergent admission accounts for notification. *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 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 strong 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 at time of service if not completed during financial clearance process.*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 at time of service. .*Maintain appropriate records, files, and timely and accurate documentation in the system of record.*Other duties as assignedFinancial Accountabilities:*Collects identified patient financial obligation amounts including residual balance if applicable. Collect liability from patient at time of service. *Educate patients on financial assistance, charity or other programs that may be available.*Refers as appropriate to on site Financial Advocate or to the Financial Advocacy CenterPatient Relations*Complete any information missing from the account to ensure accuracy at time of visit.*Transparency with patients through communication of patient liabilities..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.

Benefits

We offer more than the standard benefits!

Presbyterian employees gain access to a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more!

Learn more about our employee benefits:

https://www.phs.org/careers/why-work-with-us/benefits 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. For our employees, we offer a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more.

Presbyterian's story is really the story of the remarkable people who choose to work here. The hard work of our physicians, nurses, employees, board members and volunteers grew Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system that serves more than 875,000 New Mexicans.

About Presbyterian Healthcare Services

Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a 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 1,600 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.

About Our Regional Delivery System

Presbyterian's Regional Delivery System is a network of six hospitals and medical centers throughout rural New Mexico including locations in Clovis, Espanola, Ruidoso, Santa Fe, Socorro and Tucumcari. Our regional facilities are home to more than 1,600 clinical and non-clinical employees who help make Presbyterian the state's largest private employer with nearly 14,000 statewide employees. With a variety of services ranging from general surgery to pediatrics to heart and cancer care, our regional employees are proud to provide close-to-home care for their communities.

We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.

About New Mexico

New Mexico continues to grow steadily in population and features a low cost-of living.

Varied landscapes bring filmmakers here from around the world to capture a slice of the natural beauty New Mexicans enjoy every day. Our landscapes are as diverse as our culture - from mountains, forests, canyons, and lakes, to caverns, hot springs and sand dunes.

New Mexico offers endless recreational opportunities to explore and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

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