Insurance Verification Associate Jobs in Maryland

The Patient Access Associate (PAA) is a hospital-based, non-clinical healthcare professional who serves as the first point of contact for patients. In this pivotal role, the PAR ensures a positive patient experience during the registration and admission processes by accurately collecting essential demographic and financial information.

1.         Patient Identification and Documentation:

         Greet patients and visitors courteously and professionally.

         Accurately identify patients in the Master Patient Index to reduce erroneous duplicate medical records, maintaining a 98% accuracy rate in medical record creation.

         Update demographics per legal identification.

         Verify the information on armbands before placing them on patients.

         Explain all required documents verbally, obtain signatures appropriately, and document any inability to obtain signatures correctly, including immediate scanning into EMR, per process.

         Process all 'unable to sign' consents per process, including following legal algorithms to research and communicate with patient contacts to obtain appropriate surrogate; escalate to next steps (Care Management) when unable to find surrogate.

2.         Patient Registration and Insurance Verification:

         Conduct face-to-face interviews to accurately obtain and process patient demographic and financial information, maintaining a minimum accuracy rate of 97% for error-free registrations.

         Process and act on Real-Time Eligibility (RTE) messages, including adding, terminating, and correcting coverages.

         Identify all true self-pay patients accurately and forward to Medicaid eligibility and application staff, ensuring only true self-pay patients are screened.

         Scan all required documents into patient records and place HAR notes on accounts when necessary.

         Identify and resolve insurance verification issues, informing patients of available options, including financial assistance.

3.         Regulatory Compliance and Customer Service:

         Ensure all patients receive necessary regulatory information and enter appropriate documentation in the EMR (e.g., HIPAA, Patient Rights Brochure, IMM, NOOS, ABN, etc.).

         Explain hospital policies, procedures, and financial responsibilities to patients and their families, providing excellent customer service.

4.       Appointment Scheduling:

         Schedule appointments, surgeries, and other medical procedures according to patient and provider preferences.

         Verify insurance coverage and obtain pre-authorizations as needed.

5.       Financial Communication:

         Communicate financial responsibilities to patients and collect funds in accordance with established protocols.

         Make referrals to Charity Care and Medical Assistance when needed.

6.       Workflow Management:

         Answer and direct incoming and external calls promptly.

         Independently prioritize work, including work queue management, patient registrations, insurance verification, and other assigned tasks to meet performance and productivity standards within department deadlines.

         Identify and correct errors in accounts using appropriate tools (e.g., NextBar, OneSource).

7.       Meeting and Training Participation:

         Attend departmental staff meetings or watch videos when absent.

         Attend all required in-person training/in-services and complete all educational assignments within the required timeframe.

         Read and respond to emails during each shift.

8.       Adherence to Policies:

         Adhere to hospital policies and procedures, including timely arrival, minimal absences, appropriate attire, readiness for work, and minimal personal electronic usage.

         Adhere to the RISE values. Contribute to a positive work environment that promotes teamwork, collaboration, professionalism, and continuous improvement.

9.       Additional Responsibilities:

         Perform other duties as assigned by the Director, Manager, or Supervisor.

Experience/Education/Certification Requirements:

• High school diploma or equivalent.
• 0-11 months of direct Patient Access or healthcare registration experience.
• Strong verbal and written communication skills to interact with patients, families, and clinical teams.
• Demonstrated ability to work both independently and collaboratively in a high-paced healthcare environment.
• Excellent attention to detail and accuracy in data entry and documentation.
• Compassionate, patient-centered approach to service delivery.
• Must obtain Certified Patient Access Specialist (CPAS) certification within 8 months of hire. 

There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens.

Physical Demands - Light Work - Exerting up to 20 pounds of force occasionally and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. 

The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.

The above job description is an overview of the functions and requirements for this position.  This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.