Customer Service / Access Specialist I - Bilingual

Job Description

Job Description

Summary: 

The Access Specialist is the first point of contact for all referrals: Outpatient (OP) and Intensive In-Community (IIC). The Access Specialist registers new clients according to process, ensures accurate medical records and secures an appointment for Outpatient services or a clinician for IIC services. The Access Specialist maximizes scheduling efficiencies and access to care by managing the waitlist, no-shows, and cancellations. Performs support for psychiatric administrative functions.

Essential Duties and Responsibilities:  

• Answer calls, emails, e-facsimiles, online referrals and respond to all referrals according to targets.
• Conduct Telephonic Intakes; create/update and enter data in the client chart profile in the respective Electronic Medical Record (EMR).
• Schedule Intakes and Psychiatric Evaluations for the Outpatient program.
• Provide client portal instructions/reset passwords for new clients.
• Secure initial insurance payment info (Medicaid and commercial insurance; offer sliding scale, if necessary, etc.) and validate insurance coverage, if applicable.
• Follow up on initial 3560 authorizations (request, documents, etc.). 
• Manage the company waitlist after Intake, including monitoring clinician/APN schedules for cancellations, discharges, openings to reschedule, and filling open spots.
  • Communicate regularly with those on the company waitlist.
• Check psychiatric/clinical schedules for following day appointments; follow the process to notify team if cancellations have occurred, and actively attempt to fill all cancelled appointments.
• Ensure all medication management appointments have a next appointment scheduled for follow up on the calendar.
• Ensure medication consents are signed, and medication fact sheets are provided to the client. 
• Perform Individualized Service Plan (ISP) preparation for the APN’s completion and monitor timely execution. 
• Follow up with labs, orders, portal, requests for reports and/or letters. 
• Obtain Prior Authorizations and address prescription issues as they arise. 
• Provide referrals to clients when directed by the APN. 
• Liaise between client and APN by managing calls and emails; act as first line of communication for clients. 
• Reschedule all no-show/cancelled appointments (intakes, psychiatric, clinical) and remind clients of no-show and attendance policy.
• Ensure the no-show/cancellation procedure is adhered to by the psychiatric team. Discharge summary is required when initiated by this process.
• Assign, track, and monitor open referrals and inquiries for the Intensive In-Community (IIC) program.
• Review CYBER daily for reauthorizations and BPS’s; enter updates into HALO and follow the defined IIC BPS process for all BPS requests.
• Perform other duties as assigned.

Qualifications:  

Spanish fluency required. This position requires a Bachelor's degree in a Human Services field such as Psychology, Social Work or a related field OR 3-5 years of health care customer service-related experience in a Call Center or other similar customer service environment. Experience working with an EMR system is a plus. Proficient use of Word, Excel, and PowerPoint programs a plus. Working knowledge of basic computer functions i.e., typing, email, etc. Excellent interpersonal skills in working with individuals and groups (e.g., listening, and following directives). 

Physical Requirements:  

Regular use of the telephone and e-mail for communication is essential. Sitting for extended periods is common. Hearing and vision within normal ranges is necessary for normal conversations to receive ordinary information and to prepare or inspect documents.  

No heavy lifting is expected. Exertion of up to 10 lbs. of force occasionally may be required. Good manual dexterity for the use of common office equipment such as computer terminals, calculators, copiers, and FAX machines.  

Shift Details : Monday to Friday 9:00am - 5:30pm