PATIENT ACCESS SPECIALIST (CLINIC) - FT
REPORTS TO: CLINIC MANAGER
Under the general supervision of the Clinic Manager, the role of an Access Specialist is to assist in providing seamless, patient-oriented and timely access to services provided at the hospital and/or clinic. This position requires excellent customer service skills, both written and oral, which involves ability to communicate effectively in person or over the phone. The Specialist frequently provides the first impression of the organization and must ensure optimum internal and external customer satisfaction while obtaining demographic and payment information for accurate reimbursement. This position is primarily responsible for the registration information for the patient visit, obtaining patient demographic and third party information with a high degree of accuracy. This position also requires knowledge of insurance benefits, referrals and authorizations, and scheduling. The Specialist is responsible for maintaining knowledge of Patient Rights and Responsibilities, Consent for Treatment, HIPAA, Payors, and departmental/System policies and procedures and must be able to explain these to patients and their family members. The Specialist answers incoming calls, collects insurance copays where applicable, reviews daily schedules for accuracy, while working directly with patients, staff and physicians. Accurately schedules return/follow up appointments where applicable. Assist with other general office duties when needed.
ESSENTIAL JOB FUNCTIONS
- Supports and practices the mission and philosophy of PMC.
- Creates accurate good faith estimates in an effort to maximize up-front cash collections, in addition to, adding collection documentation where required.
- Ensures patient demographics and account information is appropriate for account type as directed.
- Accountable for maintaining a working relationship with clinical partners to ensure open communication between clinical, ancillary and other departments, and enhances patient experiences.
- Provides timely and continual coverage of assigned work area in order to offer prompt patient service and availability for all clinical partners’ registration needs. Arranges relief coverage during extended time away from registration area. Meets attendance requirements, and maintains schedule flexibility, as required. Exhibits effective time management skills by monitoring time and attendance to limit use of unauthorized overtime
- Attends department meetings and promotes positive dialogue within the team. Proactively looks for ways to improve department processes and engages in action planning to enhance both patient experience and employee engagement. Participates in activities that promote camaraderie and a friendly work environment. Enthusiastically participates in departments initiatives.
- Registers patients for services and achieves accuracy. Works patient accounts in regards to insurance identification and selection, along with required protocols associated with insurance selection. Ensures timely and efficient patient flow is facilitated and reimbursement is maximized. Properly identifies patients, inputs demographics information, and secures the required forms to ensure compliance with regulatory policies.
KNOWLEDGE & SKILLS
- Understanding of HIPAA privacy rules and adroit ability to use discretion when discussing patient related information that is confidential in nature as needed to perform duties
- Working knowledge of Microsoft programs and familiarity with database programs
- Ability to operate general office machines such as computers, facsimiles, copiers, and scanners
- Ability to effectively learn and perform multiple task, and organize work in a systematic and efficient fashion
- Ability to communicate professionally and effectively in English, both verbally and in written form
- Ability to be responsive to ever-changing matrix of hospital needs and act accordingly
- Ability to follow complex instructions and procedures, with a close attention to detail
- Knowledge of computer programs, such as Cerner (Preferred)
- Basic knowledge of medical terminology (Preferred)
- Exposure to insurance benefits; ability to decipher insurance benefit information
- One (1) or more years of customer services experience
- Prior collections experience (Preferred)
Normal patient care environment in a family practice clinic. May be required to work some weekends.
This is a Full-Time position - 40 hours per week.
The above is intended to describe the general content of and requirements of the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.