Patient Access Specialist

Schedule

• Week 1: Sunday 06:00am – 4:30pm, Tuesday 06:00am – 4:30pm, Wednesday 06:00am – 4:30pm, Thursday 06:00am – 4:30pm
• Week 2: Monday 06:00am – 4:30pm, Tuesday 06:00am – 4:30pm, Friday 06:00am – 4:30pm, Saturday 06:00am – 4:30pm

Responsibilities

• Consistently practice Patients First philosophy and adhere to high standards of customer service, including setting an example to peers and coworkers by fostering a team atmosphere.
• Respond to questions and concerns; forward, direct, and notify Team Lead or Operations Coordinator of extraordinary issues as necessary.
• Maintain patient confidentiality per HIPAA regulations.
• Provide exceptional customer service to patients, establishing a positive first impression of Northwestern Medicine; exceed consumer requests and alert management of issues or concerns requiring escalation.
• Correctly identify and collect patient demographic information in accordance with organization standards.
• Interact with various hospital departments and physicians' offices to effectively schedule and direct patients through NMHC systems in a patient/customer-friendly manner.
• Reach out to patients to schedule appointments as defined.
• Perform medical necessity checks for scheduled services and communicate options to patients if appointments fail.
• Inform patients of any issues with securing the financial account for their encounter; complete out-of-pocket estimations as requested by patients.
• Provide training and education as needed.
• Manage work schedule efficiently, completing tasks and assignments on time; complete other duties assigned by manager.
• Cross-train between various departments to ensure coverage.
• Participate in Quality Assurance reviews to ensure integrity of patient data information.
• Use effective service recovery skills to solve problems or service breakdowns when they occur.
• Utilize department and hospital policies and procedures to complete assigned tasks; adhere to all department policies and compliance requirements.
• Avoid putting patients in financial or safety risk.

Communication and Collaboration

• Communicate information to patients regarding questions about physician referrals, insurance referrals, and consultations; collect authorization numbers in appropriate systems as applicable.
• Provide a professional and constructive environment for communication across units/departments and resolve operational issues; attend intra/interdepartmental meetings which involve walking within NM Campus as needed.
• Communicate customer satisfaction issues to appropriate individuals.
• Demonstrate teamwork by helping co-workers within and across departments; communicate effectively with others, respect diverse opinions and styles, and acknowledge the assistance and contributions of others.
• Interact with internal customers to provide excellent support service to staff in departments which provide direct patient care.
• Accommodate all levels of communication ability.

Technology

• Utilize multiple online order retrieval systems to verify or print patient orders.
• Verify insurance eligibility and benefit levels through online tools (NDAS, ASF, etc.) or over the phone as necessary.
• Complete accurate handoff instructions and notes to scheduling staff by noting appropriately in Epic.
• Demonstrate ability to use all computer applications efficiently and to the capacity needed in this position.
• Run real-time eligibility (RTE) on all patients to verify insurance and follow out-of-network policies as applicable.
• Send quality Epic Messages/Telephone encounters that are descriptive and grammatically correct.

Efficiency, Process Improvement, and Business Growth

• Proactively prevent issues with patient visits by double-checking test type, preps required, assuring no conflict with other tests, verifying time and location, communicating relevant information, documenting order retrieval in notes for check-in personnel, and ensuring no duplicate patient records.
• Understand the minimum data set required for a complete registration; collect and verify critical data and update that information into the registration system.
• Understand departmental and individual quality metrics.
• Proactively analyze account activity, identify problems, and initiate appropriate actions/resolutions.
• Evaluate procedures and suggest improvements to enhance customer service and operational efficiency; participate in departmental quality improvement activities.
• Provide ideas and suggestions for process improvements within the department.
• Monitor registration and scheduling, including insurance verification, to ensure processing within prescribed quality standards; adjust processes as needed to meet standards.
• Use organizational and unit/department resources efficiently.
• Act as a training resource for new staff and a resource for coworkers, sharing process and workflow information.
• Understand that schedules may change to reflect shifting business needs; evolve and learn as healthcare policies change.

Qualifications

Required:

• High School diploma or equivalent
• 2–3 years customer service or medical office experience
• Excellent interpersonal, verbal, and written communication skills
• Proficiency in computer data-entry/typing
• Ability to read, write, and communicate effectively in English
• Basic computer skills
• Ability to type 40 wpm
• Ability to multi-task
• Customer service oriented
• Excellent organizational, time management, analytical, and problem-solving skills

Preferred:

• Additional education
• Additional language skills
• Healthcare finance and/or healthcare insurance experience
• Knowledge and experience in a healthcare setting, especially patient scheduling and/or registration