Patient Access Account Specialist -ABQ

Location Address

1100 Central Avenue SE, Albuquerque, New Mexico , United States of America

• Minimum
  
  Offer:
  
  $15.60
• Maximum
  
  Offer:
  
  $22.12

Now hiring a Patient Access Account Specialist I‑ABQ

Under the direction of the Patient Access Supervisor, the Patient Access Account Specialist I provides basic functions to clear patient accounts for government and commercial providers prior to date of service. Responsibilities include insurance verification, authorization, collection, documentation of patient demographics, benefit analysis and pre‑service collections. The specialist follows up on authorizations for scheduled and urgent/emergent procedures until service or discharge, ensuring compliance with Medicare (CMS) guidelines and other regulatory requirements such as HIPAA, EMTALA and MSPQ.

They monitor work queues, secure payment sources, and provide high‑level customer service to patients, ancillary departments, and payers. The role supports coverage to other areas and hospitals as needed.

Part time

No

Presbyterian Hospital

10‑Hour Days (United States of America)

• Customer Service and Caring Practices:
  • Achieve exceptional patient experience using CARES, AIDET and EPE tools.
  • Resolve complaints in the moment with de‑escalation processes.
  • Manage conflict and request supervisor assistance when necessary.
  • Implement PROMISE and CARES behaviors in every encounter.
  • Educate patients on insurance benefits and liabilities.
  • Ensure accounts are cleared prior to service to alleviate financial concerns.
• Encounter Components:
  • Conduct patient registration and accurate data collection.
  • Enter demographic, financial, and clinical information for account clearance.
  • Review urgent/emergent admissions for notification, clearance, and pre‑discharge authorization.
  • Obtain missing insurance details such as policy number, group number, DOB, and insurer phone.
  • Verify eligibility and benefits via electronic systems or payer contact.
  • Process work queues related to pre‑visit or emergent admissions per guidelines.
  • Ensure accurate policy IDs, group names, subscriber info, authorization numbers, and payer coordination.
  • Document actions in the system of record for audit trails.
  • Maintain knowledge of authorization requirements and payer guidelines.
  • Ensure compliance with Medicare guidelines, admissions forms, and billing requirements.
  • Complete MSPQ prior to service.
  • Focus on productivity and recommend performance improvements.
  • Track Data Quality program and correct errors before final billing.
  • Maintain accurate records and documentation.
  • Coordinate with ancillary departments for coding, diagnosis, and facility alignment.
  • Initiate authorizations with payers when appropriate.
  • Collaborate with Financial Advocates to secure payer source.
  • Monitor work queues to avoid unauthorized procedures.
  • Resolve discrepancies with physician offices regarding authorizations.
• Financial Accountabilities:
  • Collect patient financial obligations, including residual balances.
  • Arrange payment prior to service or at time of service.
  • Identify payer source before services are rendered.
  • Obtain authorization for correct CPT, facility, and service date.
• Patient Relations:
  • Contact patients pre‑visit to complete missing information.
  • Communicate patient liabilities and authorization issues timely.
  • Educate patients on benefits and financial options.
  • Provide appointment way‑finding at pre‑registration.
  • Use AIDET to alleviate anxiety and confusion.
• Quality Improvement:
  • Perform assigned patient care responsibilities.
  • Cooperate fully with risk management and investigations.
  • Report suspected or potential violations promptly.
  • Conduct all transactions in compliance with company policies.
  • Demonstrate knowledge of compliance and legal requirements.
• C.A.R.E.S Behaviors:
  • Demonstrate Collaborate, Accountable, Respect, Engage, and Serve principles.
• Perform other duties as assigned.

• High school diploma; continued education preferred.
• Pass Patient Academy with score ≥85% for non‑Patient Access candidates.
• Pass Patient Access Advocate II and III advancement tests.
• Minimum of 2 years experience in healthcare Patient Access or…