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Patient Access Representative
2 months ago
We are seeking a highly skilled and customer-focused Patient Access Representative to join our team at Northwestern Memorial Healthcare. As a key member of our access services team, you will play a critical role in ensuring a positive and efficient experience for our patients.
Key Responsibilities- Consistently demonstrate a commitment to our Patients First philosophy, providing exceptional customer service to patients and families.
- Respond to questions and concerns in a timely and professional manner.
- Forward, direct, and notify team leads or operations coordinators of extraordinary issues as necessary.
- Maintain patient confidentiality per HIPAA regulations.
- Provide exceptional customer service to patients, establishing a positive first impression of Northwestern Memorial Healthcare.
- Exceed all consumer requests and alert management of issues or concerns that require escalation.
- Correctly identify and collect patient demographic information in accordance with organization standards.
- Interact with various hospital departments and physician offices to effectively schedule and direct patients through our systems in a patient/customer-friendly manner.
- Reach out to patients to schedule appointments as defined.
- Perform medical necessity checks as necessary for scheduled services, communicate options to patients if appointment fails.
- Inform patients of any issues with securing the financial account for their encounter.
- Complete out-of-pocket estimations as requested by patients.
- Provide training and education as needed.
- Manage work schedule efficiently, completing tasks and assignments on time.
- Complete other duties assigned by manager.
- Cross-train between various departments to ensure coverage.
- Participate in Quality Assurance reviews to ensure integrity of patient data information.
- Use effective service recovery skills to solve problems or service breakdowns when they occur.
- Utilize department and hospital policies and procedures to complete assigned tasks.
- Adhere to all department policies and compliance requirements.
- Avoid putting patients in financial or safety risk.
- Communicate information to patients regarding questions about physician referrals, insurance referrals, and consultations.
- Collect authorization numbers in appropriate systems as applicable.
- Provide a professional and constructive environment for communication across units/departments and resolve operational issues.
- May attend intra/interdepartmental meetings, which involve walking within the NM campus.
- Communicate customer satisfaction issues to appropriate individuals.
- Demonstrate teamwork by helping coworkers within and across departments.
- Communicate effectively with others, respect diverse opinions and styles, and acknowledge the assistance and contributions of others.
- Interact with internal customers to provide excellent support service to staff in departments that provide direct patient care.
- Accommodate all levels of communication ability.
- Utilize multiple online order retrieval systems to verify or print patient orders.
- Verify insurance eligibility and benefit levels through the use of online tools (NDAS, ASF, etc.) or over the phone as necessary.
- Complete accurate handoff instructions and notes to scheduling staff, noting appropriately in Epic.
- Demonstrate the ability to use all computer applications efficiently and to the capacity needed in this position.
- Run real-time eligibility (RTE) on all patients to verify insurance and follow out-of-network policies as applicable.
- Send quality Epic messages/telephone encounters that are descriptive and grammatically correct.
- Be proactive in preventing issues with patient visits by double-checking the type of test, preps required, ensuring no conflict with other tests, verifying time and location, communicating relevant information, verifying documenting order retrieval in notes for check-in personnel, and ensuring there are no duplicate patient records.
- Understand the minimum data set required for a complete registration, collect and verify critical data, and update that information into the registration system.
- Understand departmental and individual quality metrics.
- Proactively analyze account activity, identify problems, and initiate appropriate actions/resolutions.
- Evaluate procedures and suggest improvements to enhance customer service and operational efficiency.
- Participate in departmental quality improvement activities.
- Provide ideas and suggestions for process improvements within the department.
- Monitor registration and scheduling, including insurance verification, to ensure processing within prescribed quality standards.
- Adjust processes as needed to meet standards.
- Use organizational and unit/department resources efficiently.
- Act as a training resource for new staff and a resource for coworkers, sharing process and workflow information.
- Understand that the schedule may change to reflect shifting business needs.
- Evolves and learns as healthcare policies change.
