Patient Access Specialist

Responsible for patient intake and access functions to support clinical flow, accurate registration, insurance verification, and financial counseling in alignment with managed care contracts, CMS regulations, and hospital policies.

• Serves as a patient liaison on arrival and initiates patient flow.
• Conducts face-to-face patient interviews to support accurate registration and financial processes.
• Registers patient demographics and insurance information, corrects data as needed, and obtains required signatures and forms.
• Collects consent for Missouri Health Connection to share PHI data.
• Assesses medical necessity guidelines with providers to help prevent denials and support CMS compliance.
• Documents actions, responds to inquiries, scans documents into the medical record, and researches registration issues to support payment.
• Verifies insurance eligibility and benefits and collects expected patient responsibility at the time of service.
• Provides financial counseling regarding payment options and financial assistance.
• Reviews provider orders for accuracy and completeness and follows up with physician offices as needed.
• Assures integrity of critical system data elements and completes assignments efficiently.
• Assists patients, third parties, physicians, and staff with billing, pre-certification, and policy-related questions.
• Helps train new employees and supports departmental workflow improvements.