Patient Access Specialist (Full Time)

About the role

Performs related processing duties for all patients being served by the hospital. As a member of the Radiation Oncology team the Patient Access Specialist is trained in performing a wide range of skilled administrative and clerical duties. Reports directly to the Director of Radiation Oncology.

Responsibilities

• Documents and forwards applicable information to facility or in office.
• Familiar with different insurance companies and their requirements in terms of precertification and authorization for surgery, testing, and procedures.
• Verifies patient information is correct, demographics and insurance coverage. If changes are required, changes the information into the Practice Management system.
• Checks in the patient in the Practice Management system.
• 3 days prior to appointment, confirmation calls should be made to the patient. Patient should be called daily until patient or family member personally confirms.
• Scans and attaches all paperwork received into EMR system and attaches and sends appropriately.
• Runs and reconciles receipts following established protocol.
• Is trained to perform all checkout duties.
• Performs other job duties as assigned.
• Able to perform administrative duties (i.e. scheduling, registration, insurance authorization, answering phone, schedule testing, refer patients as ordered by physician or mid level provider etc…).
• Performs and safely operates all equipment according to the manufacturers' instructions and protocols.
• Answers phone with correct salutation. Takes messages when appropriate.
• Greets each patient warmly and cheerfully.
• Familiar with CPT coding and Medical Necessity of testing.
• Ensures criteria met prior to scheduling testing and/or procedures, including surgery.
• Knowledgeable about insurance processing and is able to explain deductibles, co-insurance, co-payments, and how processing occurs.
• Updates and scans updated information and forms into appropriate Practice Management or EMR system.
• In the event a patient does not show for scheduled appointment, a "No Show" letter must be generated in the patient chart in the EMR system. Letter should be mailed to patient. Message in the EMR should be sent to the physician of the no show.
• Collects patient co-pay and prior balances, posting to account and giving receipt.
• Verification of insurance should be performed and noted on the careslip. Co-Pay/Balance Owed noted on the careslip.
• If patient does not leave required information, patient access specialist must call patient back in order to obtain.
• Records all messages into electronic EMR after completing request.
• Checks out the patient in the EMR system.
• Pulls all orders from checkout function.
• Schedules all return appointments.
• Schedules all testing after obtaining precertification per physician checkout orders.
• Completes and sends medical records request per physician orders.
• Completes all referrals through the EMR following correct protocol.
• Collects faxes and scans if testing. Other than testing, distributes into boxes if appropriate.
• Performs related processing duties for all patients being served by the hospital.

Qualifications

• High school diploma or equivalent required.
• Knowledge and training in medical terminology, keyboarding, and computer skills required.
• Basic skills in Microsoft Office required.
• Previous experience preferred in the areas of scheduling, EPIC preferred, insurance verification and authorization.
• Broad range of administrative and technical skills in the context of the healthcare environment.
• Impacts activities in other work areas on a frequent basis and contributes in multiple work areas.
• Demonstrates critical thought process and can work independently.
• Provides feedback to assist with decision making process.
• Works well with others.
• Documents detailed information in patient chart.
• Requires listening skills to maintain cooperative associations.

Physical Demands

• Work requires a variety of physical activities, including moving about within and outside of all hospital properties for long periods of time.
• Must be able to respond quickly and effectively to emergency and non-emergent situations.
• May be required to assist in controlling disorderly conduct or combative patients.
• Must be able to exchange accurate information with patient, family, peers and medical personnel.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.