Patient Access Specialist I

Min

USD $16.00/Hr.

Max

USD $23.64/Hr.

Overview

The Patient Access Specialist is responsible for coordinating patient entry into hospital and affiliated healthcare services. The position ensures accurate and efficient patient registration while supporting financial, compliance, and customer service functions.

Key Responsibilities

• Accurately process patient registration and admission information
• Collect and verify patient demographic details and insurance (third-party payer) information
• Perform financial collections and explain payment responsibilities
• Present and explain required legal, ethical, and compliance documents during registration
• Maintain confidentiality and compliance with healthcare regulations
• Schedule services such as mammography screenings
• Serve as a liaison between ancillary departments and Patient Access Services teams
• Provide service in patient care environments while maintaining professionalism and compassion

Knowledge & Compliance Requirements

• JCAHO standards
• Patient Rights and Responsibilities
• HIPAA privacy regulations
• HMOs and commercial insurance payers
• Departmental policies and procedures

Work Schedule

• Shift: Day
• Hours: 05:00am - 01:30pm 
• Weekends: Rotation as Specified by Department 
• FTE: 1.0 (Full-Time)

Qualifications

Education

• High School Diploma required.

Licensure / Certification / Registry

• Must successfully complete assigned annual education through Healthcare Business Insights.

Experience

• Minimum of one (1) year of business office experience preferred, including:
  • Patient Access
  • Billing and collections
  • Insurance principles and practices
  • Accounts receivable
• Completion of twelve (12) hours of coursework in a business or healthcare-related field may substitute for business office experience.
• Previous Patient Access experience strongly preferred.

Knowledge, Skills, and Abilities

• Comprehensive understanding of Patient Access Service functions to support accurate registration and reimbursement processes.
• Strong interpersonal and patient relations skills with demonstrated professionalism, tact, and sensitivity when interacting with patients, families, staff, and the public.
• Ability to maintain emotional composure and professionalism in fast-paced or high-stress environments.
• Proficient computer skills including data entry, electronic documentation, and use of registration software and healthcare systems.
• Excellent attention to detail with strong critical thinking and problem-solving abilities.
• Effective oral and written communication skills with exceptional customer service focus.
• Demonstrated flexibility, sound judgment, and initiative when managing competing priorities.
• Ability to work independently while contributing positively to team and organizational goals.
• Skilled in patient education, persuasion, and negotiation related to financial and registration processes.
• Knowledge of medical terminology, CPT procedural coding, ICD-10-CM diagnosis coding, and hospital billing claims preferred but not required.

Responsibilities

Job Responsibilities

• Completes all steps of pre-registration and registration; verifies patient identity and demographic information through appropriate tools.
• Identifies and captures appropriate health insurance benefit eligibility based on contract/regulatory differentiation.
• Facilitates appropriate billing of claims and hospital reimbursement.
• Obtains and validates proper consent for patient treatment.

Scheduling & Patient Coordination

• Schedules patients for Mammography procedures efficiently and effectively according to established protocol, including modality, location, facility capabilities, insurance requirements, type of exam, patient preferences, and urgency.

Patient Education & Financial 

• Educates patients and others regarding resolution of billing issues, private pay options, collection efforts, coordination of benefits, third-party and governmental payment criteria, insurance coverage, payments, and denials.
• May serve as a liaison between external resources and patients on issues requiring SMH involvement.
• Coordinates with SMH Patient Financial Services, Utilizat