PATIENT ACCESS SPECIALIST I
4 weeks ago
This position offers direct support to the nursing staff, including, taking all patient phone calls, place orders, schedule appointments, submit prior authorizations, and SART data entry.
Hours for this position will be Monday through Friday, 7:00am to 3:30pm with no evenings Rotating weekends and holidays may be required, depending on staffing needs.
Responsibilities:
* Review, verify and enter the patient's demographic information to ensure data integrity.
* Schedule appointments according to the physician templates for similar types of physicians, generally at one office or multiple session timeshares (single specialty phone room or front desk environment).
* Schedule appointments according to the templates/departmental scripts while meeting business unit scheduling accuracy requirements.
* Obtain chief complaints in order to schedule appropriately.
* Take incoming calls demonstrating the essential skills documented in the Telephone Courtesy Standards.
* Understand UPMC 72-hour appointment requirement and work to ensure guidelines are met.
* Appropriately distribute/triage phone calls to other areas and/or clinical providers (billing, nurse, operations lead, etc.).
* Treat all patients with respect and demonstrates the behaviors learned in the Patient Ambassador Program.
* Routinely attend department meetings and on-going in-service and training programs, to present and exchange pertinent information.
* Work the overflow call list and Audiocare report.
* Review and verify the patient's insurance information.
* Coordinate access to care for patients within own department or location.
* Monitor patient wait list report.
* Compile and send new patient packets or flags patient if needs to be completed upon arrival.
* Knowledgeable about various reasons for patient calls such as prescription refills, how to triage clinical issues, participating insurances, questions about physicians, etc.
* Take responsibility to escalate to appropriate clinical or supervisory personnel when needed, including thorough and accurate documentation of telephone encounter for messaging.
* Function at multiple sites as requested by supervisor.
* Answer multi-line telephone system. The number of calls taken must be within 90% of the daily average calls per day per agent.
* Give basic information to patients (directions, parking information, and required preparation for appointment).
Qualifications:
* Completion of HS Diploma/equivalent and 1 year of experience in a medical office, customer service, inbound call center (preferred), or other relevant health care setting will be considered.
* Associates degree and 6 months of experience in a medical office, customer service, inbound call center (preferred), or other relevant health care setting preferred
Must have experience with personal computer based applications, including email and experience with other various office equipment. Must be able to multitask at a high level. Able to interact with a variety of external and internal constituents, including patients, patients' families, internal physicians, referring physicians or their clinical/office staff, insurance companies, nurses. Experience with/knowledge of medical terminology and multi-line telephone systems is preferred. Electronic scheduling system experience is preferred. Must be able to learn and apply third party payer guidelines and reimbursement practices. Basic knowledge of health insurance preferred. Must be able to maintain confidential information. Must have strong interpersonal, organizational, and communication skills and be able to remain professional and courteous when dealing with sensitive issues and stressful circumstances.
Licensure, Certifications, and Clearances:
* Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran
UPMC has a Center for Engagement and Inclusions that is charged with executing leading-edge and next- generation diversity strategies to advance the organization's diversity management capability and its national presence as a diversity leader. This includes having Employee Resources Groups, such as PRIDE Health or UPMC ENABLED (Empowering Abilities and Leveraging Difference) Network, that support the implementation of our diversity strategy.
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