Patient Access Specialists are instrumental in ensuring the efficient and effective flow of patients’ access needs throughout the facility. Responsible for greeting and registering patients, gathering appropriate demographic and insurance information, scheduling appointments, laboratory tests and ancillary services and the collection of co-payments. Position must fully understand the ramification and impact of incomplete or inaccurate information to revenue cycle. Position may float to other areas within the facility to include nursing units, rehabilitation services, etc. to assist with patient flow.
ESSENTIAL JOB FUNCTIONS
Supports and models behaviors consistent with Pioneer Medical Center’s and facility’s mission, vision, values, code of business conduct and service expectations. Meets all mandatory organizational and departmental requirements. Maintains competency in all organizational, departmental and outside agency standards as it relates to the environment, employee, patient safety or job performance.
Greets patients and identifies any red flag symptoms requiring triage/assessment by nurse, completes on-line registration information gathering complete demographic and insurance information that results in the ability to provide correct information for patients, guarantor, and insurance follow-up. Competently and courteously educates patients about various forms that require their signature.
Schedules, reschedules and coordinates appointments in a manner that meets the patient’s needs and assists the department in the management of patient flow utilizing knowledge of physician/non-physician scheduling protocols. May schedule and enter orders for ancillary services via the information systems. Instructs patients on specific preparations and/or restrictions necessary to prepare for ancillary procedures as defined by clinical protocols. Floats to provide front desk support at the various nursing units as may be needed.
Initiates collection of co-payments in accordance with each patient’s individual insurance requirements. Collects deposits on account from self-pay patients. Accepts all other payments on accounts and provides cash receipts for all transactions. Maintains and reconciles cash drawer bank deposit by following written reconciliation policies and procedures ensuring each cash drawer balances daily.
Assists walk-in patients with non-encounter based access (i.e., blood pressure checks) and coordinates communication with the clinical providers or other patient care staff as appropriate.
Coordinates with patients, providers, nursing staff to ensure Medicaid Passport and other authorizations for referrals required by insurance carriers are obtained and entered into the scheduling system for reimbursement purpose.
Performs patient check out/procedure and scheduling processes.
Responsible for monitoring waiting areas to ensure areas are clean and neat. Monitoring to ensure patient flow is optimized and wait times do not exceed 15 minutes.
Prints and reconciles the missing encounter to ensure all encounter forms are accounted for. Provides appropriate communication to the clinic department manager.
Responsible for receiving all incoming faxes, mail, freight and packages and for timely distribution to appropriate areas.
Responsible to courteously and accurately answer and direct physician and consumer telephone calls per department standards in a clear audible voice. Pages, transfers and delivers calls to appropriate destinations using predetermined questions format. Articulates Pages are conducted in a friendly, clear, readable and concise manner. Responds to basic inquiries regarding the facilities’ services, program offerings and physician specialty information.
Screens incoming nursing unit telephone calls for appropriate referrals to nurse, physician and/or non-physician provider.
May assist nursing staff with initiating follow-up calls to patients for no-shows, referral appointments and other general questions.
Performs other duties as assigned or needed to meet the needs of the department/organization.
KNOWLEDGE, SKILLS AND ABILITIES
COMPLEXITY & DIFFICULTY: