Patient Access Account Specialist I

Location Address:

9521 San Mateo NE
Albuquerque, NM 87113-2237

Compensation Pay Range:

Minimum Offer $16.38
Maximum Offer $25.57
Now Hiring: Patient Access Account Specialist I

Summary:

Build your Career. Make a Difference. Presbyterian is hiring a skilled Patient Access Account Specialist I.

Under the direction of the Patient Access Supervisor, the Patient Access Account Specialist I supports the financial clearance of patient accounts for government and commercial payers prior to service. Responsibilities include insurance verification, authorization processing, benefit review, patient demographic documentation, and pre-service collections. This role ensures timely follow-up on authorizations for scheduled, urgent, and emergent procedures and admissions through the date of service or discharge. The Specialist must maintain a working knowledge of Medicare (CMS) guidelines and other regulatory requirements applicable to Patient Access, including HIPAA, EMTALA, and MSPQ compliance standards.

Type of Opportunity: Full time
Job Exempt: No
Job is based: Reverend Hugh Cooper Administrative Center
Work Shift: Days (United States of America)

Responsibilities:

• Verify insurance eligibility, benefits, and payer requirements to ensure accounts are financially cleared prior to service.
• Obtain, track, and follow up on authorizations for scheduled, urgent, and emergent procedures and admissions.
• Complete patient registration and accurately collect and document demographic, insurance, financial, and clinical information.
• Educate patients on insurance coverage and financial responsibility while collecting applicable patient balances.
• Maintain compliance with Medicare (CMS), HIPAA, EMTALA, MSPQ, and payer guidelines, ensuring accurate documentation and account resolution.

Qualifications:

• This role follows a hybrid schedule, Monday through Friday, 9:00 AM to 5:30 PM.
• High school diploma, continued education preferred
• External and Internal Non-Patient Access Candidates: Pass Patient Academy with passing score of 85% or higher
• Previous completion and passing of Patient Access Advocate II and III Advancement test.
• A minimum of 2 years of work experiences in healthcare setting within Patient Access and/or billing plus strong customer service background.
• Strong knowledge and understanding of insurance and financial processing of accounts.
• Proficient in EPIC ADT system
• Specialty Certifications: CHAA, CHAM or other industry equivalent certification preferred