Patient Access Specialist - Diagnostic Scheduler

At St. Tammany Health System, delivering world-class healthcare close to home is our goal. We are committed to attracting and retaining the very best professionals for every position in our health system. The health system is nestled in the heart of Covington on the north shore of Lake Pontchartrain, offering a peaceful, scenic, and community-oriented area with an abundance of amenities.

About the Role

The Patient Access Specialist is responsible for completing efficient and organized processes in registration, check-in/check-out, admission, insurance initiation and verification, benefit research for inpatients/outpatients, and scheduling of appointments. This role requires excellent customer service skills and flexibility in work shifts. The Specialist ensures accurate information collection while maintaining patient confidentiality and awareness of HIPAA regulations. They also promote patient throughput and volume growth.

Responsibilities

• Verify insurance coverage, benefits, and obtain/initiate authorizations.
• Complete registration pathways in HIS systems.
• Receive, maintain, clarify, enter, and/or validate physician orders.
• Schedule appointments and determine third-party payer liability for billing.
• Check medical necessity and handle daily batching/posting of point-of-service payments.
• Resolve previous and current patient balances through direct conversations.
• Maintain positive relationships with the healthcare team and serve as a resource for physicians, staff, and patients regarding orders, insurance, referrals, and other issues.
• Train and mentor other Patient Access Representatives and Specialists in technical aspects of the job.
• Understand and solve complex problems related to governmental entitlement programs, commercial insurance requirements, and contractual obligations.

Requirements

• High school diploma or equivalent; some college preferred.
• At least 1 year of previous customer service experience in an office or medical office environment, including scheduling, admitting, and/or financial counseling.
• Excellent written and verbal communication skills.
• Ability to work in a fast-paced professional environment.
• Demonstrated competency in Patient Access Representative duties, typically obtained through 12 months of direct experience.
• Understanding of CPT and ICD-10 coding, basic anatomy/physiology, outpatient diagnostic testing terminology, Medicare guidelines, HMO/PPO contracts, and insurance billing processes.
• Excellent organizational skills and a professional, neat work environment.
• Some positions may be designated as essential personnel during disaster situations (e.g., hurricanes).

Preferred Qualifications

• Certified Healthcare Access Associate (CHAA) through the National Association of Healthcare Access Management (NAHAM).
• Completion of a medical terminology course.
• Bilingual (preferably Spanish).

Physical Demands

• Must possess good physical health.
• Standing, sitting, or walking for long periods of time.
• Lifting at least 20 pounds.
• Ability to work with a moderate level of noise.
• Constant (67%-100%): Handling/feeling, talking, hearing, seeing.
• Frequently (34%-66%): Reaching.
• Occasionally (1%-33%): Lifting, carrying, pushing/pulling, climbing (stairs, ladders, etc.), balancing, stooping, crouching.

Schedule

Full-time, 40 scheduled weekly hours. Work shift: 8:30 AM – 5:00 PM, Monday – Friday.