Patient Access Specialist (On-Site)

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Core Job Summary:

The Patient Access Specialist (On-Site) is responsible for coordinating a wide range of complex duties that support front end revenue cycle and clinic functions for hospital and clinic operations that impact the patient experience. Serves as functional expert for department peers and oversees team adherence with established policies and procedures.

Core Responsibilities:

• Obtains, confirms, and enters demographic, financial, and clinical information necessary for financial clearance of scheduled patient accounts.

• Contacts patients’ families or physicians’ offices to obtain missing insurance information.

• Verifies insurance and confirms insurance eligibility of patient coverage benefits, notifying patient and referring physician in the event of failed eligibility.

• Collaborates with scheduling departments to identify add-on patients.

• Obtains necessary authorizations, pre-certifications, and referrals.

• Notifies patients of liabilities prior to date of service and collects funds.

• Maintains appropriate records, files, and accurate documentation in the system of record.

• Serves as a lead resource for lower-level Patient Services staff. Recommends new approaches to management for enhancing performance and productivity.

• Deploys critical thinking while responding to a variety of technical issues from patients, physicians and employees via phone, email, web messages, fax, or email.

• Works independently and deals effectively with stress, due to heavy workload and the handling of complex patient inquiries.

• Serves as a role model, facilitator, and coach in developing a culture of compassion and caring through building healthy relationships among staff, patients, and families.

• Projects a professional appearance and pleasant demeanor creating a welcoming atmosphere.

• Adheres to University and unit-level policies and procedures and safeguards University assets.

Department Specific Functions:

• Tier 1 essential worker that provides critical functions that cannot be paused in traditional and non-traditional healthcare settings 

• Subject to potential contact with patients who can transmit infectious diseases.

•   Coordinates wide range of hospital and clinic front end revenue cycle and clinic support functions from prearrival to post discharge services. 

• Obtains, confirms, and accurately enters demographic, financial, and clinical HIPAA protected information. 

• Assists in monitoring staff productivity and quality of work through proactive review of key performance indicators.  

• Serves as functional expert resource and provides on the job training for Patient Access Service team. 

• Navigates multiple systems simultaneously and independently to service patients promptly in a fast paced, constantly changing environment. 

• Monitors and maintains all work queues. 

• Assists patients in navigating self-serve technology options in person or remotely.

•   Performs pre-service validation prior to patient’s appointment for in person or virtual visits.  

• Conducts critical communication with patients or legal guardian facilitating the understanding of and obtaining signature on multiple consents, assignment of benefits, and notices including but not limited to Consent for Treatment and Conditions of Admissions, Advance Directives, HIPAA, No Surprise Billing, Good Faith Estimate, Off Campus Medicare Co-insurance, ABNs, and MSPQ, prior to services being rendered. 

• Provides financial counseling services at check-in, creates estimates, explains benefits, and notifies patients of self-pay liabilities including previous balances, and collects funds. 

• Collaborates with providers and clinical schedulers in coordinating and scheduling complex follow up care onsite or remotely. 

• Handles high volume of inbound and outbound calls to and from patients and customers, listening to customers’ needs and providing helpful solutions.