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Outpatient Patient Access Specialist
2 months ago
Key Responsibilities:
- Uphold our commitment to exceptional customer service by performing all tasks in alignment with our service philosophy and standards.
- 1) Welcome and acknowledge all patients and their families promptly and courteously.
- 2) Introduce patients to our offerings, detailing what they can expect during their visit. Maintain professionalism in all communications.
- 3) Inform patients about the anticipated duration of their visit, including registration and clinical service times.
- 4) Clarify the reasons for collecting demographic, socio-economic, and financial information, ensuring patients understand how their data is protected and utilized to enhance their care.
- 5) Conclude interactions with a clear expression of gratitude.
- When registering walk-in patients, identify insurance coverage, available benefits, patient financial responsibilities, and collect necessary co-payments.
- 1) Utilize electronic systems to verify coverage while engaging with the patient and discuss findings transparently.
- 2) For uninsured patients, assess urgent care needs and follow appropriate charity protocols, involving leadership for urgent care decisions.
- 3) Ensure compliance with policies when assisting walk-in patients, collaborating with physicians and clinical leaders to address order quality issues.
- Manage security authorizations and precertifications for both inpatient and outpatient services.
- 1) Notify relevant departments and personnel regarding uninsured patients or those with limited insurance coverage.
- 2) Maintain proficiency in software for eligibility verification.
- 3) Identify potential financial risks related to Medicare and Medicaid coverage and communicate these to the appropriate teams.
- 4) Initiate patient communication regarding the implications of unapproved services.
- 5) Collect and analyze clinical data as required by payer guidelines for prior authorization and precertification.
- Ensure accuracy in pre-registration and registration processes.
- 1) Accurately enter patient demographic and insurance details into the system, focusing on correct carrier code assignment and benefit records.
- 2) Pre-register and register patients according to established procedures, ensuring all necessary documentation is prepared.
- 3) Provide thorough explanations of documents requiring patient signatures during registration.
- 4) Manage calls effectively to complete pre-registrations.
- 5) Generate and process all required documentation for each registration.
- Engage in team-building activities and other duties as assigned by leadership.
- 1) Contribute to quality initiatives by participating in team projects.
- 2) Attend all required training sessions to stay updated on job responsibilities.
- 3) Assist leadership with special assignments as needed to support departmental goals.
Education and Experience Required:
- High School Diploma with a minimum of 2 years of experience in Patient Access or related fields such as medical office support, billing, insurance, hospitality, or call centers. Intermediate math skills are preferred.
Knowledge, Skills & Abilities Required:
- Typing speed of 25 WPM; basic understanding of web-based systems; proficiency in data entry.
Physical Requirements and Working Conditions:
- Ability to prioritize and organize tasks effectively; strong communication and negotiation skills; independent decision-making capability; flexibility to work varied hours as needed, including evenings and weekends; teamwork orientation.
Additional Notes: This job description outlines the general nature and level of work expected from the incumbent. It is not intended to be an exhaustive list of all responsibilities and tasks required. The incumbent may be asked to perform other related duties as necessary.
