Patient Access Specialist

Patient Access Specialist

Responsible for staffing multiple hospital entry points to provide registration-related functions including the Emergency Department, Outpatient Imaging, Outpatient Surgery, and others. Responsible for pre-registration, registration, verification activities and gathering and processing of patient demographic and financial information. Responsible for identifying source of payment and collecting payment and interfacing with insurers, members of the hospital and medical staff. Maintains current knowledge of Federal and State regulatory compliance guidelines and joint commission requirements. Promotes departmental objectives through cooperation and quality performance. Cross training required in multiple administrative support functions and registration points. Works in fast paced, stressful environment requiring staffing weekdays and weekends all hours. Depending on the assigned facility, scheduled shift, and other factors, may be responsible for physically assisting patients into the registration area and/or providing bedside registration.

Process: Captures and enters accurate patient demographic and financial information via telephone interviews, hard copy documentation (mail-in, facsimile, etc.), and/or direct patient contact. Adapts interview process to the age of the patient/family member. Enters all information gathered into the patient management system. Depending on the assigned facility, scheduled shift, and other factors, the ability to physically meet the patient where they are in their care to complete job role and utilize Workstation on Wheels (WOW) to complete job functions at registration area or at the bedside, including movement from bay to bay and throughout waiting rooms depending on assigned work area. May include the following activities: physically accompanying patient to registration area or service area via wheelchair (including locking and unlocking wheelchair), ambulatory assist, or support guide. Improve WQ volume and validate future appointments for expedited service. Trained and competent in electronic health record downtime as needed. Proficient in transcribing orders in patient management system. Assists with the rescheduling of patient appointments when needed. Scheduling worker's comp patients (applicable by center). Compliance: Ensures all appropriate documentation is complete and included on the patient chart, in accordance with Federal and State regulatory guidelines, and The Joint Commission requirements. Follows federal guidelines in providing Medicare documents to patient, explaining content and receiving written signature. Customer Service: Coordinates with insurance verification and financial counseling to ensure appropriate insurance authorization is obtained prior to the scheduled appointment. Assists patient with billing issues and questions about insurance coverage and refers unsponsored or underinsured patients to financial navigator. Maintains up to date knowledge and competency of a wide variety of third-party plans and insurance carriers, both participating and non-participating plans, which are complex and ever changing. Models an understanding of diversity by creating and maintaining an environment that supports and respects diversity. Anticipates patient related mobility needs and provides appropriate assistance. Provides a warm welcome and hand off by accompanying patients and or family members to the designated service area or waiting room when necessary. Standing, walking, providing safe wheelchair transport and bending for wheelchair locking and unlocking, and mobilizing registration equipment may be required to provide customer service, enable the completion of registration-related duties, and accompanying patients to their designated service area. Acts with honesty and integrity with employees and stakeholders, showing and speaking with respect for the rights of others, human dignity, local culture, and Novant Health's mission, vision and values.Financial: Creates estimates for patient responsibility and discusses insurance benefits and amount due with all patients. Communicates the financial liability to the patient and collects the patient's portion of the financial responsibility. Processes payments in accordance with policies and procedures. Prepares a daily bank deposit for revenues received during the workday. Prepares and delivers bank deposits to the local banks when needed. Refers to Financial Navigators as needed. Ability to process and close cash drawers. Ability to enroll patient in payment plans. Validates future appointments to ensure registration and pricing are complete prior to arrival. Extensive benefit knowledge. Completes basic financial counselor processes as needed. Quality Improvement: Complies with all organizational policies and procedures. Maintains satisfactory attendance at Patient Access educational and departmental meetings. Attends all mandatory education sessions and takes advantage of continuing professional education opportunities. Demonstrates a personal commitment to continuous quality improvement through active participation. Organizes and manages time effectively to optimize productivity. Meets departmental registration goals in accordance with policy and procedures. Responsible for resolving work queues (WQ) in patient management system. Report WQ trends and issues to leader. Professional: Possesses the ability to accept change in a positive manner and implement change with positive results. Demonstrates a positive image of a caring and concerned organization at all times. Maintains composure in difficult situations. Uses best judgment to resolve patient problems or refer issues to department supervisor.Communication: Work within a team to achieve patient and team goals. Share and initiate regular and professional communication with co-workers. Participate in regular staff meetings. Identifies opportunities to improve processes based on feedback from staff and customers. Assists key stakeholders such as emergency transport with patient demographic information when needed. Also, be knowledgeable of the digital phone operations for call transfers and emergency paging.Human Experience: Gain customer confidence through competence, good communication, and trust building behaviors. Show courage through creating and sharing innovative ideas to improve the experience for both patients and peers. Round on patients throughout waiting rooms to create meaningful connections and keep patients informed of visit details (delays/wait times). Model the service standards through consistently engaging in Always Event behaviors and view feedback through the patient lens. Recognize and value the unique differences and similarities in both our team members and patients to create an inclusive environment where diversity is celebrated. Explain all processes to patients in plain language and utilize teach back to ensure understanding. Know and model the mission, vision and values, and how they relate to role-specific responsibilities. Model our people credo through a passion to care for each other, our patients and our communities. Medical record handling: Responsible for accurately and efficiently handling all aspects of medical records. Ensures proper completion of Medical Record release forms and checks for proper identification prior to release of imaging exams. Scans miscellaneous correspondence into the electronic record. Releases patient information to insurance companies and other physician practices following established guidelines. Assists with patient correspondence.Emergency Communications: Be knowledgeable of the emergency notification process and be prepared to coordinate and direct EMS personnel during emergent patient care events including, without limitation, within the imaging center.

Radiology Image Data Management: Transmission both to and from outside sources (hospitals, clinics, etc.) are needed for image comparisons during interpretations. This task is shared with the clinical imaging team members. Interpretation Services: Coordinates and schedules outside interpreters for patients that need language translation assistance. This process is reviewed at the time of scheduling, confirmed with the patient, and, as applicable to imaging, then confirmed the day of the radiology exam appointment. Knowledge of both telephone services and online web use are required. Training on the online video iPAD is required as a part of the orientation for this role. Manage iPAD Intake Documents: Patient Access Specialist will oversee and facilitate the initial start of digital history sheets for patients receiving exams in the center. Each team member should be knowledgeable of the function of each iPAD and be able to answer high level questions from patients of digital history sheets for patients receiving exams in the center. All clinical questions should be forwarded to the clinical team member on site. Imaging Center Liaison: When staffing weekend shifts, the Patient Access Specialist serves as the Imaging Center Liaison. These duties require knowledge of security systems, HVAC systems and proper notification of Emergency Medical Services if needed. Also, it is the responsibility of the Patient Access Specialist to alert the area Manager of any safety or patient care concerns that happen within the center. Patient Safety and Team Member Safety: It is extremely important for the Patient Access Specialist to be informed, educated and knowledgeable of safety procedures throughout the assigned area, including, without limitation, the imaging center. Conflict resolution at the front desk and the early notification of local authorities must be discussed and the team member should feel comfortable initiating these protocols when needed. Extra Cleaning and Preventive Measures: All Patient Access Specialists will be diligent in their efforts to educate and ensure patients wear the proper PPE during their time at Novant Health, including, without limitation, the imaging center. These protocols must be enforced and knowledge of the options for patients must discussed in a professional manner. Additional duties around infection prevention may include management of HEPA Filter devices, stocking additional PPE supplies, requesting supplies, and performing additional cleaning to ensure a safe environment for others.Additional Scheduling Duties: When Radiology Equipment fails, or Radiology Staff is not available to complete the scheduled patient appointments, the Patient Access Specialist is often asked to contact and reschedule patient exams. Both a professional and apologetic demeanor is required when making these calls. Also, review MD orders upon arrival and through direct communication to the Technologist and referring Physician, assign appropriate imaging exams within the radiology schedule.

What We're Looking For

Education: High School Diploma or GED, required.

• Experience:
  • Minimum one year experience in patient access, registration, billing, cash collection, insurance and/or pre-certification in a medical environment, preferred.
  • One year Customer Service experience in any field, preferred.
  • One year of clerical experience in medical office setting, preferred. Other related experience may be considered in lieu of medical office experience.
• Additional Skills Required: Demonstrated knowledge of insurance plans and coordination of benefits, registration processes, collection and cash receipting in compliance with regulatory standards, emergency codes and appropriate responses, and applicable federal and state healthcare regulations. Excellent interpersonal and communication skills, possesses experience and competency in customer relation skills. Ability to organize and prioritize work in a stressful environment with changing priorities. Must be able to interact with individuals of all cultures and levels of authority