Patient Access Specialist - HVC | Full Time

About the Role

The patient access specialist performs administrative duties including, but not limited to: referrals, maintain provider schedules, prior authorizations for procedures/tests/medications, schedule outside procedures/testing, and performs related processing duties for all patients being served by respective clinic. Duties are performed in the EMR system as appropriate. The patient access specialist is trained in performing a wide range of skilled administrative and clerical duties.

Supervision

Reports directly to Practice Manager.

Responsibilities and Duties

• Knowledge of CPT coding and Medical Necessity of testing
• Ensures criteria met prior to scheduling testing and/or procedures, including surgery
• Greets each patient warmly and cheerfully
• Knowledgeable about insurance processing and able to explain deductibles, co-insurance, co-payments, and how processing occurs
• Handles incoming referrals
• Answers phone with correct salutation. Takes messages when appropriate
• Records all messages into electronic EMR
• Verifies patient information, demographics and insurance coverage is correct. If changes are required, changes the information in the EMR
• Updates and scans updated information and forms into appropriate EMR system
• Scan and attach all paperwork received into EMR system and attach and send appropriately
• 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
• Verification of insurance should be performed when necessary
• Performs other job duties as assigned

Education and Work Experience

• High school diploma or equivalent required
• Knowledge and training in medical terminology, keyboarding, and computer skills preferred
• Basic skills in Microsoft Office preferred
• Previous experience preferred in the areas of scheduling
• Computer literacy, required
• 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
• Make decisions based on departmental policy
• 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 Environment

• 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