Pool Patient Access Specialist 1

Under general supervision of the Supervisor/Patient Access Team Leader, follows established policies and procedures; gathers and records all necessary information in the process of generating a hospital account. Responsible for interviewing patients to confirm or obtain demographic and confidential clinical and financial information necessary to accurately and efficiently register, verify insurance eligibility and benefits, identify and collect patient copays, and identify those services that require an insurance authorization. Able to identify and explain forms that require the patient's signature. Recognizes and adheres to CMS, JCAHO and HIPAA requirements when creating a hospital account. May work directly with nurses, medical staff, ancillary departments, insurance carriers and other external professionals to assist patients with obtaining health care and financial services. Responsible for performing job duties in accordance with the mission, vision and values of Tampa General Hospital.

Essential Functions

• Gather and verify all necessary demographic, clinical, and financial information to create accurate hospital accounts.
• Interview patients to confirm and collect information, ensuring a smooth registration process.
• Verify patient insurance eligibility and benefits through direct communication with insurance carriers.
• Identify services requiring pre-authorization and inform patients accordingly.
• Collect patient copayments and inform patients about their financial responsibilities prior to services rendered.
• Discuss payment options and financial assistance programs available to patients.
• Ensure all necessary forms are completed, signed, and accurately filed in accordance with hospital policies and regulatory requirements (CMS, JCAHO, HIPAA).
• Maintain confidentiality of patient information at all times.
• Work closely with nurses, medical staff, and ancillary departments to facilitate patient care and service access.
• Identify and resolve issues related to patient registration, insurance verification, and account discrepancies.
• Act as a liaison between patients and other departments to address concerns and provide assistance.
• Utilize Electronic Health Records (EHR) and other healthcare software to accurately enter and manage patient data.
• Generate reports as needed to monitor patient access metrics and departmental performance.
• Stay updated on changes in healthcare regulations, insurance policies, and hospital procedures.
• Participate in training and development opportunities to enhance skills and knowledge relevant to the role.

Education Qualifications

• High School Diploma or GED

Skills and Abilities

• Healthcare Policies and Procedures: Understanding of hospital protocols, including registration processes, insurance verification, and authorization requirements.
• Medical Terminology: Knowledge of basic medical terms, procedures, and diagnoses relevant to patient registration and insurance verification.
• Interpersonal Communication: Strong verbal communication skills for effectively interviewing patients and explaining processes clearly.
• Attention to Detail: Ability to accurately gather, record, and verify demographic, clinical, and financial information.
• Problem-Solving: Competence in identifying issues related to insurance or patient information and finding effective solutions.
• Technical Proficiency: Skills in using EHR systems and other healthcare software to manage patient information accurately.
• Organizational Skills: Ability to manage multiple tasks efficiently, prioritizing responsibilities in a fast-paced environment.
• Confidentiality Awareness: Strong commitment to maintaining patient confidentiality and data security in accordance with HIPAA guidelines.
• Collaboration: Ability to work effectively with nurses, medical staff, and insurance representatives to facilitate patient access to services.
• Cultural Sensitivity: Ability to interact respectfully with diverse patient populations, understanding and addressing their unique needs.