Patient Access Specialist

Role Summary

Responsible for managing internal and external physician scheduling by providing the highest quality personalized care to all those the employee encounters. In addition to checking in infusion patients by following check-in policies and procedures; manages and directs incoming phone calls to the clinic; schedules follow-up appointments, diagnostics and treatments; assists as needed infusion desk coordinator and medical scheduler/receptionist. The employee shall maintain positive work relationships with other members of the clinic staff and access team to facilitate clinical and financial patient care.

Responsibilities

• Reception of patients to include arriving patient, collecting co-pay and deductibles due at time of service
• Schedules appointments, including follow-ups, diagnostics, treatments
• Management of incoming phone calls to the center
• Ensure authorizations obtained before treatment; responsible for communicating with clinical staff to ensure no authorizations are missed
• Coordination of scheduling patients from outside physicians seeking to have their patient serviced at the infusion center for bloods, injections, and chemotherapy; to include pre-registering the patient, contacting patient's insurance company(ies) to obtain schedule of benefits, policy effective date and termination date, if applicable, verifying good authorization, and scheduling the 1st appointment with patient access and booking the infusion chair
• For all patients scheduled in the infusion center the patient access specialist will provide assistance to the coordinator in checking pharmacy orders based on insurance authorization and communicate with the authorization specialist any discrepancies
• Insure that the patient has a valid ONC6 number assigned to them and create one when needed
• Working as a patient financial counselor as needed by advising patients of programs that we offer and directing the patient to the appropriate party such as the financial navigator for assistance
• Informs patient of payment policy; Coordinates arrangements for patients needing financial assistance
• Completes summary of payment options for patients; refers patients to Patient Liaison who meet the eligibility requirements to apply for Medicaid
• Meets with new patients before initial physician consult; obtains and verifies all demographic information, completes comprehensive summary of financial responsibility and payment options
• Responsible for follow-up with patients who need updated demographics, Insurance information, or have an outstanding financial responsibility
• Other duties as assigned by patient access manager
• Additional responsibilities may be assigned to help drive our mission of improving the lives of everyone living with cancer

Required Qualifications

• Minimum of 3 years' experience in medical office required
• Knowledge of insurance benefits, authorization process and contracting also required
• Must be able to work independently, possess strong organizational and communication skills and to adhere to established goals and deadlines
• High School Diploma or GED

Essential Competencies

• Attendance is an essential job function
• Manages incoming calls into the Infusion Center by answering the phone within 3 rings professionally and courteously
• Communication with an Authorization specialist regarding any issues that arise in orders or with changes of orders
• ICD-9/10 and CPT coding a plus
• Medicare, Medicaid and private-payer practices and regulations