Patient Access Specialist

Patient Access Representative

Serves as a patient advocate and resource through the scheduling, pre-registration, registration, admitting/discharge and authorization process. Greets, screens and checks in patients, families vendors and visitors in a professional manner while working to exceed customer service expectations. Pre-registers current and prospective patients which includes: performing verification of demographic and insurance eligibility/benefit information, identifying and communicating out of pocket liability, providing cost estimations as well as attempting to collect in advance or at time of service as well as making referrals to Patient Financial Counselor for self-pay or inability to pay.

Major Responsibilities & Duties:

• Provides excellent customer service to any individuals presenting for clinic care, surgery, admissions or in need of direction by being able to assist any who present to their Access location with their admitting, registration/check-in, collections or other needs as identified.
• Maintains excellent communication and positive rapport with all points of contact which include internal and external entities, documenting pertinent discussions and details of correspondence in all applicable systems to provide tracking and point of reference.
• Responsible for obtaining and communicating accurate benefit information and eligibility, pre-determination/pre-authorization as well as detailed benefit and patient liabilities per insurance company requirements and established time frames, i.e. online vs. telephone to ensure credible coverage and benefits are in place.
• Follows established protocols and procedures for verification and collection of pertinent demographics.
• Communicates with Medical Unit Manager or Director to determine bed assignment and resource availability at time of admission if not performed in advance of patient presentation.
• Communicates arrival of surgical patients following registration or admission providing transport assistance as needed to pertinent care unit.
• Monitors patient care waiting areas, being situationally aware of setting to ensure a clean, safe and comfortable environment for anyone presenting to BTNRH.
• Processes incoming calls both internal and externally to aid in services which may include but are not limited to: scheduling, pre-registration, processing nurse call information, pharmacy refills and referral requests, physician and/or staff paging needs, financial counseling queries, admission/discharge notifications as well as vetting special requests and questions as needed.
• Assists in coordinating and scheduling interpretive services as identified needed.
• Responsible for opening and closing of clinic/admission locations ensuring security systems are utilized as directed.
• Works to collect co-payment and payment on account at time of service and is responsible for preparing daily bank deposits at appropriate intervals, carefully following payment and cash controls as directed.
• Communicates in a positive and professional manner with the patient / guarantor on any scheduling, registration, authorization or financial issues, including assisting with Financial Assistance application or referrals.
• Confirms legal guardianship status when applicable, obtaining legal guardianship documentation and consents.

Knowledge, Skills, and Abilities:

• Ability to apply knowledge of electronic medical records, charts and medical terminology.
• Knowledge of insurance terms, reimbursement procedures, rates and policies related to medical terminology.
• Ability to maintain petty cash funds, make change and process credit cards.
• Ability to give attention to detail and follow established standards and procedures.
• Knowledge of Explanation of Benefits (EOB), CPT, HCPC and Diagnosis Codes.
• Must have excellent verbal/written communication skills to communicate effectively with physicians, clinicians, patients and families.
• Knowledge of telephone etiquette required.
• Ability to handle multiple tasks at a time.

Required Qualifications:

• High school diploma or equivalent required.
• Basic Life Support (BLS) certification within 120 days of transfer or hire required.

Preferred Qualifications:

• Minimum of 3 years' experience working in a clinic and/or hospital setting preferred.
• Knowledge of Explanation of Benefits (EOB) preferred.

Physical Requirements, Equipment Usage, Work Environment:

• Position is relatively sedentary in a normal office administrative environment involving minimum exposure to physical risks. Will use office equipment such as a computer/laptop, monitor, keyboard, and a general workstation set-up.

Care and respect for others is more than a commitment at Boys Town it is the foundation of who we are and what we do.

At Boys Town, we cultivate a culture of belonging for all employees that respects their individual strengths, views, and experiences. We believe that our differences enable us to be a better team one that makes better decisions, drives innovation, and delivers better business results.

Boys Town has been changing the way America cares for children and families since 1917. With over a century of service, our employees have helped us grow from a small boardinghouse in downtown Omaha, Nebraska, into one of the largest national child and family care organizations in the country. With the addition of Boys Town National Research Hospital in 1977, our services branched out into the health care and research fields, offering even more career opportunities to those looking to make a real difference.

Our employees are our #1 supporters when it comes to achieving Boys Town's mission, which is why we are proud of their commitment to making the world a better place for children, families, patients, and communities. A unique feature for employees and their dependents enrolled in medical benefits are reduced to no cost visits for services performed by a Boys Town provider at a Boys Town location. Additional costs savings for the employee and their dependents are found in our pharmacy benefits with low to zero-dollar co-pays on certain maintenance drugs. Boys Town takes your mental health seriously with no cost mental health visits to an in-network provider. We help our employees prepare for retirement with a generous match on their 401K or 401K Roth account. Additional benefits include tuition reimbursement, parenting resources from our experts and professional development opportunities within the organization, just to name a few. Working at Boys Town is more than just a job, it is a way of life.

This advertisement describes the general nature of work to be performed and does not include an exhaustive list of all duties, skills, or abilities required. Boys Town is an equal employment opportunity employer and participates in the E-Verify program. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and/or expression, national origin, age, disability, or veteran status. To request a disability-related accommodation in the application process, contact us at View phone number on click.appcast.io.